Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 3671 | CO |
NPI | 1558597914 |
---|---|
Provider Name | Dr. Kimberly Beth Schmidt |
First Address | Fort Collins, CO 80526-6109 |
Second Address | Fort Collins, CO 80526-6109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2009 |
Last Update Date | 29/05/2009 |