Provider Demographics
NPI:1275303331
Name:SCHWARTZ, KIMBERLY D
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:D
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:D
Other - Last Name:QUIGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10985 MUSIC ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURY
Mailing Address - State:OH
Mailing Address - Zip Code:44065-9561
Mailing Address - Country:US
Mailing Address - Phone:206-375-1049
Mailing Address - Fax:
Practice Address - Street 1:10985 MUSIC ST
Practice Address - Street 2:
Practice Address - City:NEWBURY
Practice Address - State:OH
Practice Address - Zip Code:44065-9561
Practice Address - Country:US
Practice Address - Phone:206-375-1049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANA60219279163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health