Provider Demographics
NPI:1982660197
Name:TRIMBOLI, NANCY J (DC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:J
Last Name:TRIMBOLI
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 1:706 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-1612
Mailing Address - Country:US
Mailing Address - Phone:219-836-8890
Mailing Address - Fax:219-836-2344
Practice Address - Street 1:706 RIDGE RD
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1612
Practice Address - Country:US
Practice Address - Phone:219-836-8890
Practice Address - Fax:219-836-2344
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001441A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100373120Medicaid
INU38165Medicare UPIN
IN404850AMedicare PIN