Provider Demographics
NPI:1871888636
Name:SCHIEBERL, KIMBERLY KAY (RPH)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KAY
Last Name:SCHIEBERL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4890 MARSH RD
Mailing Address - Street 2:T0365
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-1123
Mailing Address - Country:US
Mailing Address - Phone:517-347-9955
Mailing Address - Fax:517-347-9955
Practice Address - Street 1:4890 MARSH RD
Practice Address - Street 2:T0365
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1123
Practice Address - Country:US
Practice Address - Phone:517-347-9955
Practice Address - Fax:517-347-9955
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302026895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist