Provider Demographics
NPI:1538296033
Name:SCHWEITZER, KIMM LAREE (RN)
Entity Type:Individual
Prefix:
First Name:KIMM
Middle Name:LAREE
Last Name:SCHWEITZER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22953 308TH AVE
Mailing Address - Street 2:
Mailing Address - City:PRESHO
Mailing Address - State:SD
Mailing Address - Zip Code:57568-5105
Mailing Address - Country:US
Mailing Address - Phone:605-869-2511
Mailing Address - Fax:605-473-5677
Practice Address - Street 1:100 CLAUDIA BLVD
Practice Address - Street 2:
Practice Address - City:LOWER BRULE
Practice Address - State:SD
Practice Address - Zip Code:57548
Practice Address - Country:US
Practice Address - Phone:605-473-5526
Practice Address - Fax:605-473-5677
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDSD-RN R031822163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse