Healthcare Provider Details

I. General information

NPI: 1982837563
Provider Name (Legal Business Name): CHRISTINA MARIE ZIMMERMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2009
Last Update Date: 08/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 E CHANDLER BLVD STE 104
PHOENIX AZ
85048-7647
US

IV. Provider business mailing address

4545 E CHANDLER BLVD STE 104
PHOENIX AZ
85048-7647
US

V. Phone/Fax

Practice location:
  • Phone: 480-961-2366
  • Fax: 480-961-2367
Mailing address:
  • Phone: 480-961-2366
  • Fax: 480-961-2367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP3432
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: