Healthcare Provider Details

I. General information

NPI: 1235677683
Provider Name (Legal Business Name): AMBER LYNN ZIMMER CNM, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER LYNN ROSTY R.N

II. Dates (important events)

Enumeration Date: 02/06/2017
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2032 E 22ND ST
CASPER WY
82601-5081
US

IV. Provider business mailing address

2032 E 22ND ST
CASPER WY
82601-5081
US

V. Phone/Fax

Practice location:
  • Phone: 307-262-5134
  • Fax: 331-204-1133
Mailing address:
  • Phone: 307-262-5134
  • Fax: 331-204-1133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number28533.1604
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28533
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: