Healthcare Provider Details

I. General information

NPI: 1437424645
Provider Name (Legal Business Name): JENNIFER ZIMLICH DUNN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2012
Last Update Date: 10/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 CARONDOLET CT W
MOBILE AL
36608-5717
US

IV. Provider business mailing address

116 CARONDOLET CT W
MOBILE AL
36608-5717
US

V. Phone/Fax

Practice location:
  • Phone: 251-295-5110
  • Fax:
Mailing address:
  • Phone: 251-295-5110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1093960
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: