Healthcare Provider Details

I. General information

NPI: 1598566648
Provider Name (Legal Business Name): JESSICA NICOLE ZIMMERMAN THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1681 E FLAMINGO RD STE 2
LAS VEGAS NV
89119-5274
US

IV. Provider business mailing address

1681 E FLAMINGO RD STE 2
LAS VEGAS NV
89119-5274
US

V. Phone/Fax

Practice location:
  • Phone: 702-720-7802
  • Fax:
Mailing address:
  • Phone: 702-720-7802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: