Provider Demographics
NPI:1386800845
Name:ZIMMERLEE, ERIN IRENE (BA, BSN, RN)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:IRENE
Last Name:ZIMMERLEE
Suffix:
Gender:F
Credentials:BA, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 NE VIKING CT
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3961
Mailing Address - Country:US
Mailing Address - Phone:541-337-9960
Mailing Address - Fax:
Practice Address - Street 1:2577 NE COURTNEY DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7638
Practice Address - Country:US
Practice Address - Phone:541-322-7521
Practice Address - Fax:541-330-4642
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201041781RN163WP0809X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical