Provider Demographics
NPI:1184926610
Name:SCHOLL, JEANINE ANN MARIE
Entity type:Individual
Prefix:
First Name:JEANINE
Middle Name:ANN MARIE
Last Name:SCHOLL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E WEST HWY
Mailing Address - Street 2:1416
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-8200
Mailing Address - Country:US
Mailing Address - Phone:727-247-5128
Mailing Address - Fax:
Practice Address - Street 1:1200 E WEST HWY
Practice Address - Street 2:1416
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-8200
Practice Address - Country:US
Practice Address - Phone:727-247-5128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-05
Last Update Date:2010-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR192154363LF0000X
FLARNP9258059363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily