Provider Demographics
NPI:1881761294
Name:REMIEN, KIM SCHULTZ (NP)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:SCHULTZ
Last Name:REMIEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2832 FIELDSTREAM LN
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-7154
Mailing Address - Country:US
Mailing Address - Phone:298-282-7826
Mailing Address - Fax:208-282-7850
Practice Address - Street 1:1784 SCIENCE CENTER DR
Practice Address - Street 2:IDAHO STATE UNIVERSITY
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83402-1575
Practice Address - Country:US
Practice Address - Phone:208-282-7826
Practice Address - Fax:208-282-7850
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-240A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily