Provider Demographics
NPI:1588169601
Name:JENNIFER LYNN ZIMMERMAN DNP CRNP LLC
Entity type:Organization
Organization Name:JENNIFER LYNN ZIMMERMAN DNP CRNP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CRNP
Authorized Official - Phone:570-357-3954
Mailing Address - Street 1:308 TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:HARDING
Mailing Address - State:PA
Mailing Address - Zip Code:18643-7153
Mailing Address - Country:US
Mailing Address - Phone:570-357-3954
Mailing Address - Fax:
Practice Address - Street 1:308 TERRACE AVE
Practice Address - Street 2:
Practice Address - City:HARDING
Practice Address - State:PA
Practice Address - Zip Code:18643
Practice Address - Country:US
Practice Address - Phone:570-357-3954
Practice Address - Fax:207-245-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-29
Last Update Date:2018-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty