MEDICARE: KIMBERLY VANSWEDEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	10199528-3501	UT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	260022408	OTHER	UT	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124495577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY VANSWEDEN

Provider Business Mailing Address
First Line	:	7525 GARLAND WAY BLDG 928
Second Line	:
City	:	HILL AFB
State	:	UT
Zip	:	84056-5700
Country	:	US
Telephone Number	:	801-777-3075
Fax Number	:

Provider Business Practice Location Address
First Line	:	7525 GARLAND WAY
Second Line	:
City	:	HILL AFB
State	:	UT
Zip	:	84056-5700
Country	:	US
Telephone Number	:	801-777-3075
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2015
Last Update Date	:	03/06/2026

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Directions to “ KIMBERLY VANSWEDEN ” Practice Location

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