Doctor Name: | MARY LOU ZIMMERMANN |
NPI Number: | 1063689701 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | CO1387 |
Business Practice Address: | 10120 Longview Dr Lone Tree, CO - 801249764 |
Business Phone Number: | 3036621916 |
Business Fax Number: | 3036621918 |
Mailing Address: | 10120 Longview Dr, LONE TREE |
State: | CO |
Postal Code: | 801249764 |
Phone Number: | 3036621916 |
Fax Number: | 3036621918 |
NPI Enumeration Date: | 05/12/2008 |
NPI Last Update Date: | 05/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | CO1387 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |