MEDICARE: RACHEL ZIMMERMAN RN, FNP

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
1	363LF0000X	Family Nurse Practitioner	78059	KS
2	363LF0000X	Family Nurse Practitioner	2018000607	MO

General Provider Information

NPI Number	:	1386169001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL ZIMMERMAN RN, FNP

Provider Business Mailing Address
First Line	:	4320 WORNALL RD
Second Line	:	SUITE 50
City	:	KANSAS CITY
State	:	MO
Zip	:	64111
Country	:	US
Telephone Number	:	816-931-3312
Fax Number	:	816-531-9862

Provider Business Practice Location Address
First Line	:	4320 WORNALL RD STE 50
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-5943
Country	:	US
Telephone Number	:	816-931-3312
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2017
Last Update Date	:	09/19/2018

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