Healthcare Provider Details

I. General information

NPI: 1356265375
Provider Name (Legal Business Name): KIMBERLY SCHAEFBAUER MSOTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E INTERSTATE AVE STE 3
BISMARCK ND
58503-1226
US

IV. Provider business mailing address

3352 DOUBLEDAY DR
BISMARCK ND
58503-8066
US

V. Phone/Fax

Practice location:
  • Phone: 701-751-1125
  • Fax:
Mailing address:
  • Phone: 701-527-1968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number1144
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: