Doctor Name: | MS. LESLIE Z ZIMMERMAN-VIDMAR |
NPI Number: | 1033240031 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | RN190839 |
Business Practice Address: | 36100 Euclid Ave Willoughby, OH - 440944456 |
Business Phone Number: | 4409425400 |
Business Fax Number: | |
Mailing Address: | 7200 Mentor Ave, MENTOR |
State: | OH |
Postal Code: | 44060 |
Phone Number: | 4409425400 |
Fax Number: | |
NPI Enumeration Date: | 03/08/2007 |
NPI Last Update Date: | 06/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | RN190839 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |