Healthcare Provider Details

I. General information

NPI: 1184936155
Provider Name (Legal Business Name): NANCY LYNN ZIPPERER M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2010
Last Update Date: 07/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3821 KOHLER MEMORIAL DRIVE
SHEBOYGAN WI
53081
US

IV. Provider business mailing address

262 ANN DRIVE
PLYMOUTH WI
53073
US

V. Phone/Fax

Practice location:
  • Phone: 920-208-9648
  • Fax: 920-208-6316
Mailing address:
  • Phone: 920-207-7688
  • Fax: 920-208-6316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1662-154
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: