Individual
KIMBERLY M SCHNEIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
20B PROFESSIONAL PARK DRIVE, MARYVILLE, IL 62062
(618) 288-1480
(618) 288-2407
Mailing address
1836 LACKLAND HILL PARKWAY, ATTN CREDENTIALING DEPT, ST LOUIS, MO 63146-3572
(314) 872-1308
(314) 810-1399
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085003987
IL
Other
Enumeration date
02/17/2011
Last updated
02/17/2011
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