Healthcare Provider Details

I. General information

NPI: 1710153580
Provider Name (Legal Business Name): HANNAH ZIMMERMAN MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E CALGARY AVE STE 1
BISMARCK ND
58503-5648
US

IV. Provider business mailing address

227 16TH ST W STE 100
DICKINSON ND
58601-4675
US

V. Phone/Fax

Practice location:
  • Phone: 701-355-6044
  • Fax: 701-355-6299
Mailing address:
  • Phone: 701-225-0767
  • Fax: 701-225-7123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1053
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: