Provider Demographics
NPI:1427261627
Name:ZIMMERMAN, LORRAINE (APRN)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 RESEARCH PKWY
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-4214
Mailing Address - Country:US
Mailing Address - Phone:860-510-0888
Mailing Address - Fax:860-510-0020
Practice Address - Street 1:20 RESEARCH PKWY
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-4214
Practice Address - Country:US
Practice Address - Phone:860-510-0888
Practice Address - Fax:860-510-0020
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001803363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner