Provider Demographics
NPI:1790813335
Name:NILMEIER, SUSAN E (DC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:E
Last Name:NILMEIER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 GIBSON AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-4331
Mailing Address - Country:US
Mailing Address - Phone:831-372-6699
Mailing Address - Fax:831-375-2251
Practice Address - Street 1:572 GIBSON AVE
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-4331
Practice Address - Country:US
Practice Address - Phone:831-372-6699
Practice Address - Fax:831-375-2251
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0148570Medicare ID - Type UnspecifiedPROVIDER #