Provider Demographics
NPI:1932779121
Name:ZIMA, VIVA (FNP-C)
Entity type:Individual
Prefix:
First Name:VIVA
Middle Name:
Last Name:ZIMA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:VIVA
Other - Middle Name:
Other - Last Name:VILISTUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:42101 N 41ST DR STE 148
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3819
Mailing Address - Country:US
Mailing Address - Phone:623-688-2105
Mailing Address - Fax:949-288-0264
Practice Address - Street 1:42101 N 41ST DR STE 148
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086-3819
Practice Address - Country:US
Practice Address - Phone:623-688-2105
Practice Address - Fax:949-288-0264
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ258821363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner