Provider Demographics
NPI:1447803283
Name:KIMMEL, MEGHAN SCHOENFELDER (FNP, ACAGNP)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:SCHOENFELDER
Last Name:KIMMEL
Suffix:
Gender:F
Credentials:FNP, ACAGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2278 IVORY CT
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-1350
Mailing Address - Country:US
Mailing Address - Phone:541-805-8980
Mailing Address - Fax:
Practice Address - Street 1:2643 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1936
Practice Address - Country:US
Practice Address - Phone:970-298-6600
Practice Address - Fax:970-372-0955
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-21
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1640997163WC0200X
COAPN.0996680-NP363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care