Provider Demographics
NPI:1992959472
Name:SCHMIDT, NICOLE MARIE (DC)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MARIE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:MARIE
Other - Last Name:BOLDUC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2201 WILLAMETTE STREET
Mailing Address - Street 2:SUITE C
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3091
Mailing Address - Country:US
Mailing Address - Phone:541-683-5678
Mailing Address - Fax:541-343-7350
Practice Address - Street 1:2201 WILLAMETTE STREET
Practice Address - Street 2:SUITE C
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3091
Practice Address - Country:US
Practice Address - Phone:541-683-5678
Practice Address - Fax:541-343-7350
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3884111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor