Healthcare Provider Details

I. General information

NPI: 1316634355
Provider Name (Legal Business Name): TAYLOR ZIMMERMAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYLOR LYNN SCHULTZE OTR/L

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 H ST
FAIRBURY NE
68352-1119
US

IV. Provider business mailing address

2200 H ST
FAIRBURY NE
68352-1119
US

V. Phone/Fax

Practice location:
  • Phone: 402-729-3351
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2402
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: