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NPI Code Detail

MEDICARE: NICOLE LYNN ZIMMERMAN PHARMD

MEDICARE: NICOLE LYNN ZIMMERMAN PHARMD
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist17865-40WI

General Provider Information

NPI Number : 1255062600
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE LYNN ZIMMERMAN PHARMD
Provider Business Mailing Address
First Line : 3129 FERNDELL ACRES DR
Second Line :
City : HOBART
State : WI
Zip : 54155-9069
Country : US
Telephone Number : 208-866-9746
Fax Number :
Provider Business Practice Location Address
First Line : 2851 UNIVERSITY AVE
Second Line :
City : GREEN BAY
State : WI
Zip : 54311-5855
Country : US
Telephone Number : 208-866-9746
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2022
Last Update Date : 05/21/2026

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Directions to “ NICOLE LYNN ZIMMERMAN PHARMD” Practice Location

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