MEDICARE: BARBARA ZIMMER 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
1	164W00000X	Licensed Practical Nurse	PN096573L	PA

General Provider Information

NPI Number	:	1629203211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA ZIMMER LPN

Provider Business Mailing Address
First Line	:	218 HOLLY ST
Second Line	:
City	:	CLIFTON HEIGHTS
State	:	PA
Zip	:	19018-2610
Country	:	US
Telephone Number	:	610-638-9196
Fax Number	:

Provider Business Practice Location Address
First Line	:	218 HOLLY ST
Second Line	:
City	:	CLIFTON HEIGHTS
State	:	PA
Zip	:	19018-2610
Country	:	US
Telephone Number	:	610-638-9196
Fax Number	:

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

Provider Enumeration Date	:	05/26/2009
Last Update Date	:	09/22/2016

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