Healthcare Provider Details

I. General information

NPI: 1689811028
Provider Name (Legal Business Name): CHRISTINE R ZIMMERMAN MPH RD CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2009
Last Update Date: 03/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 COLE BLVD STE 120
LAKEWOOD CO
80401-3405
US

IV. Provider business mailing address

1536 COLE BLVD STE 120
LAKEWOOD CO
80401-3405
US

V. Phone/Fax

Practice location:
  • Phone: 720-284-7276
  • Fax:
Mailing address:
  • Phone: 720-284-7276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number861154
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: