Provider Demographics
NPI:1023639697
Name:SCHEMMER, JONATHAN AARON (HIS)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:AARON
Last Name:SCHEMMER
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 265
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:MN
Mailing Address - Zip Code:55741-0265
Mailing Address - Country:US
Mailing Address - Phone:218-343-0177
Mailing Address - Fax:
Practice Address - Street 1:230 1ST ST S STE 109
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792-2670
Practice Address - Country:US
Practice Address - Phone:218-288-5889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2870237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1184811267OtherNPI