MEDICARE: MR. STEVEN ROBERT ZIMMERMAN ATC, RN

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	2255A2300X	Athletic Trainer	LAT-2875	NC
2	163WX0800X	Orthopedic Registered Nurse	276949	NC

General Provider Information

NPI Number	:	1942387717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN ROBERT ZIMMERMAN ATC, RN

Provider Business Mailing Address
First Line	:	157 1ST AVE
Second Line	:
City	:	SYLVA
State	:	NC
Zip	:	28779-5450
Country	:	US
Telephone Number	:	304-552-7476
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 HEALTHCARE DR STE 203
Second Line	:
City	:	SYLVA
State	:	NC
Zip	:	28779-5146
Country	:	US
Telephone Number	:	285-865-5318
Fax Number	:	828-586-7887

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/04/2019

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