Provider Demographics
NPI:1831254879
Name:ZIMMERMAN, BRENDA LEE (ARNP)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:LEE
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:LEE
Other - Last Name:NEDICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:517 LISTON ST
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:IA
Mailing Address - Zip Code:51019-5022
Mailing Address - Country:US
Mailing Address - Phone:785-477-3681
Mailing Address - Fax:
Practice Address - Street 1:863 1400 LN
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-3123
Practice Address - Country:US
Practice Address - Phone:970-902-2042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA167085363LF0000X
COC-APN.0004121-C-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily