Healthcare Provider Details

I. General information

NPI: 1770707903
Provider Name (Legal Business Name): KIMBERLY SCHUMACHER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 SPRING HEIGHTS DR
NORTH VERNON IN
47265-2139
US

IV. Provider business mailing address

104 SPRING HEIGHTS DR
NORTH VERNON IN
47265-2139
US

V. Phone/Fax

Practice location:
  • Phone: 812-346-9901
  • Fax: 812-346-5908
Mailing address:
  • Phone: 812-346-9901
  • Fax: 812-346-5908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number28116343A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: