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NPI Code Detail

MEDICARE: JENNIFER PITTMAN ZIMMERMAN LPN

MEDICARE: JENNIFER PITTMAN ZIMMERMAN LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse16561NE

General Provider Information

NPI Number : 1104389881
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER PITTMAN ZIMMERMAN LPN
Provider Business Mailing Address
First Line : 320 N 5TH ST
Second Line :
City : BEATRICE
State : NE
Zip : 68310-2957
Country : US
Telephone Number : 402-223-1545
Fax Number :
Provider Business Practice Location Address
First Line : 320 N 5TH ST
Second Line :
City : BEATRICE
State : NE
Zip : 68310-2957
Country : US
Telephone Number : 402-223-1545
Fax Number : 402-223-1547
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2019
Last Update Date : 04/10/2019

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