Healthcare Provider Details

I. General information

NPI: 1982904652
Provider Name (Legal Business Name): JENNIFER L ZIMMERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2010
Last Update Date: 10/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 N 21ST ST SUITE 100
CAMP HILL PA
17011-2207
US

IV. Provider business mailing address

401 EDINBURGH RD
MIDDLETOWN PA
17057-3494
US

V. Phone/Fax

Practice location:
  • Phone: 717-761-0930
  • Fax: 717-761-0465
Mailing address:
  • Phone: 717-761-0930
  • Fax: 717-761-0465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: