Healthcare Provider Details

I. General information

NPI: 1033413588
Provider Name (Legal Business Name): SARAH JANE ZIMMER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH JANE PIERSON

II. Dates (important events)

Enumeration Date: 12/26/2010
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 W MAIN CENTRACARE HEALTH SYSTEM-MELROSE
MELROSE MN
56352
US

IV. Provider business mailing address

10382 AUGUSTA DR
SAUK CENTRE MN
56378-4864
US

V. Phone/Fax

Practice location:
  • Phone: 320-256-4231
  • Fax:
Mailing address:
  • Phone: 612-702-9042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR 160987-9
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: