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General NPI Number Information
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NPI Number | 1275254740
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Entity Type | Individual
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Provider Name | LEXIE MADISON ZIMMERMAN PA
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Gender | Female
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Dates
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Enumeration Date | 09/05/2022
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Last Update Date | 09/05/2022
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Provider Practice Location Address
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Address Line | 19161 HEALTHY WAY UNIT 100
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-4491
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Country | US
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Telephone | 302-645-3010
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Fax |
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Provider Business Mailing Address
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Address Line | 705 HERRINGBONE RD
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City | PORT ROYAL
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State | PA
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Zip | 17082-7651
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Country | US
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Telephone | 717-363-0012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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