Provider Demographics
NPI:1154796886
Name:ZIMMERMAN, JEFFERY (CRNA)
Entity type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 KIMMER DR STE 1000
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-8454
Mailing Address - Country:US
Mailing Address - Phone:303-388-4461
Mailing Address - Fax:720-639-8946
Practice Address - Street 1:9101 KIMMER DR STE 1000
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-8454
Practice Address - Country:US
Practice Address - Phone:303-388-4461
Practice Address - Fax:720-639-8946
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0993027-CRNA367500000X
IL209014078367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered