Provider Demographics
NPI:1033483912
Name:SCHOAF, KIM MARIE (RN)
Entity type:Individual
Prefix:MS
First Name:KIM
Middle Name:MARIE
Last Name:SCHOAF
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 1:115 E ESTERO LN
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-4232
Mailing Address - Country:US
Mailing Address - Phone:623-547-3218
Mailing Address - Fax:
Practice Address - Street 1:115 E ESTERO LN
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-4232
Practice Address - Country:US
Practice Address - Phone:623-547-3218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN137401390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program