Provider Demographics
NPI:1770707903
Name:SCHUMACHER, KIMBERLY (RN)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:SCHUMACHER
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 1:104 SPRING HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:NORTH VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47265-2139
Mailing Address - Country:US
Mailing Address - Phone:812-346-9901
Mailing Address - Fax:812-346-5908
Practice Address - Street 1:104 SPRING HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:NORTH VERNON
Practice Address - State:IN
Practice Address - Zip Code:47265-2139
Practice Address - Country:US
Practice Address - Phone:812-346-9901
Practice Address - Fax:812-346-5908
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28116343A163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200723300AOtherDEVELOPMENTAL THERAPY
IN200666040AOtherNURSING-RN
IN200667700AOtherDEVELOPMENTAL THERAPY