Healthcare Provider Details

I. General information

NPI: 1710249511
Provider Name (Legal Business Name): SUZANNE MARIE ZIMMERMANN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZANNE JONES CRNP

II. Dates (important events)

Enumeration Date: 06/08/2012
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 DEFENSE HWY
ANNAPOLIS MD
21401-8919
US

IV. Provider business mailing address

166 DEFENSE HWY STE 101
ANNAPOLIS MD
21401-8921
US

V. Phone/Fax

Practice location:
  • Phone: 410-224-3390
  • Fax: 410-224-3370
Mailing address:
  • Phone: 410-224-3390
  • Fax: 410-224-3370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR083493
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: