Individual
MRS. KIMBERLY S SCHNEIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
421 S LANDMARK AVE, BLOOMINGTON, IN 47403-5003
(812) 332-4468
(812) 331-3311
Mailing address
421 S LANDMARK AVE, BLOOMINGTON, IN 47403-5003
(812) 332-4468
(812) 331-3311
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10000808A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007377-1
NY STATE LICENSE
NY
01
—
1000808A
STATE LICENSE
IN
01
—
AA10004294
WASHINGTON STATE LICENSE
WA
Enumeration date
09/20/2006
Last updated
07/08/2007
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