Healthcare Provider Details

I. General information

NPI: 1477467611
Provider Name (Legal Business Name): SARAH ZIMMERMAN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W KANSAS ST
LIBERTY MO
64068-2060
US

IV. Provider business mailing address

255 PERSIMMON RD
RAYMORE MO
64083-8815
US

V. Phone/Fax

Practice location:
  • Phone: 816-781-0035
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026044607
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: