Healthcare Provider Details

I. General information

NPI: 1700412582
Provider Name (Legal Business Name): ASHLEY RUTH ZIMMERMAN MSN, AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1194 OAK VALLEY DR STE 80B
ANN ARBOR MI
48108-8942
US

IV. Provider business mailing address

PO BOX 639295 DEPT 93394
CINCINNATI OH
45263-9295
US

V. Phone/Fax

Practice location:
  • Phone: 734-975-5000
  • Fax: 734-975-0376
Mailing address:
  • Phone: 484-346-1692
  • Fax: 855-618-6655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4704321491
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: