Provider Demographics
NPI:1790807790
Name:SCHWENDIMAN, CAROLEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CAROLEE
Middle Name:
Last Name:SCHWENDIMAN
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 1:2990 LA JOYA DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-3739
Mailing Address - Country:US
Mailing Address - Phone:801-277-8274
Mailing Address - Fax:
Practice Address - Street 1:2990 LA JOYA DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-3739
Practice Address - Country:US
Practice Address - Phone:801-277-8274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT194294-3102163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health