Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 31003500A | IN |
N | 2251E1200X | Ergonomics | 31003500A | IN |
N | 225XE1200X | Ergonomics | 31003500A | IN |
N | 225XH1200X | Occupational Therapist - Hand | 31003500A | IN |
N | 2251H1300X | Human Factors | 31003500A | IN |
N | 225XH1300X | Human Factors | 31003500A | IN |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 31003500A | IN |
N | 225XP0200X | Occupational Therapist - Pediatrics | 31003500A | IN |
N | 225XR0403X | Driving and Community Mobility | 31003500A | IN |
NPI | 1669527198 |
---|---|
Provider Name | Mr. Russell W Schimmell |
First Address | Evansville, IN 47714-0137 |
Second Address | Evansville, IN 47714-0137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000218741 | ANTHEM BC & BS PIN (01) | IN |