Provider Demographics
NPI:1750104170
Name:SCHOMAKER, DESTINY NICOLE
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:NICOLE
Last Name:SCHOMAKER
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 1:3605 VANNEST AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-2664
Mailing Address - Country:US
Mailing Address - Phone:513-885-9472
Mailing Address - Fax:
Practice Address - Street 1:3605 VANNEST AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-2664
Practice Address - Country:US
Practice Address - Phone:513-885-9472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant