Provider Demographics
NPI:1700103512
Name:SCHNURBUSCH, KIMBERLY A (APRN, ACNP-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:SCHNURBUSCH
Suffix:
Gender:F
Credentials:APRN, ACNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211699
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-3699
Mailing Address - Country:US
Mailing Address - Phone:866-849-0692
Mailing Address - Fax:
Practice Address - Street 1:880 SW 145TH AVE STE 202
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-6171
Practice Address - Country:US
Practice Address - Phone:866-849-0692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29897363LF0000X
NC5007185363LF0000X
OH0038040363LF0000X
MO2025002556363LF0000X
TX1191270363LF0000X
TN37998363LF0000X
AZ321686363LF0000X
GAGAA-NP003391363LF0000X
FLAPRN9267258363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5007185OtherSTATE LICENSE