MEDICARE: KIMBERLY MARIE SCHWIGER B.A.

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1285756338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY MARIE SCHWIGER B.A.

Provider Business Mailing Address
First Line	:	2270 MEADOWLAKE RD
Second Line	:	#609
City	:	CONWAY
State	:	AR
Zip	:	72032-2562
Country	:	US
Telephone Number	:	501-269-8377
Fax Number	:

Provider Business Practice Location Address
First Line	:	2526 HIGHWAY 65 S
Second Line	:	SUITE #202
City	:	CLINTON
State	:	AR
Zip	:	72031-6657
Country	:	US
Telephone Number	:	501-745-4584
Fax Number	:

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

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	07/08/2007

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