MEDICARE: MICHELE ZIMMERMAN

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	163WD0400X	Diabetes Educator Registered Nurse	RN092943	AZ

General Provider Information

NPI Number	:	1518544519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE ZIMMERMAN

Provider Business Mailing Address
First Line	:	910 W 5TH AVE STE 380
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99204-2948
Country	:	US
Telephone Number	:	509-570-5470
Fax Number	:	509-624-3315

Provider Business Practice Location Address
First Line	:	77 W FOREST AVE STE 202
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-1483
Country	:	US
Telephone Number	:	928-773-2033
Fax Number	:	928-214-3981

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

Provider Enumeration Date	:	03/25/2021
Last Update Date	:	03/02/2026

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Directions to “ MICHELE ZIMMERMAN ” Practice Location

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