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General NPI Number Information
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NPI Number | 1780669390
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Entity Type | Individual
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Provider Name | KIMBERLY R. ZIMMERMAN
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Gender | Female
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 18101 LORAIN AVE
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City | CLEVELAND
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State | OH
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Zip | 44111-5612
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Country | US
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Telephone | 216-476-7326
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Fax | 216-476-7831
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Provider Business Mailing Address
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Address Line | 18101 LORAIN AVE
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City | CLEVELAND
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State | OH
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Zip | 44111-5612
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Country | US
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Telephone | 216-476-7326
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Fax | 216-476-7831
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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 | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | A045334
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | DR.0054948
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | 35.054521
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | 35.054521
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License Number State | OH
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