=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306931829
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EVELYN HARKINS ZIMMERLY CRNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2006
-----------------------------------------------------
Last Update Date | 02/23/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1010 DELAFIELD RD
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15215-1802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-360-3034
-----------------------------------------------------
Fax | 412-360-6887
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 720 FOURTH STREET
-----------------------------------------------------
City | OAKMONT
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15139-1530
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-826-1538
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | VP001516C
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------