Provider Demographics
NPI:1851866537
Name:SCHUMACHER, NICHOLAS EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:EDWARD
Last Name:SCHUMACHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11901 ABESS BLVD APT 4233
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-6044
Mailing Address - Country:US
Mailing Address - Phone:304-549-3945
Mailing Address - Fax:
Practice Address - Street 1:1639 SOUTHSIDE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1987
Practice Address - Country:US
Practice Address - Phone:904-725-2286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH12610OtherFLORIDA BOARD OF CHIROPRACTIC