Provider Demographics
NPI:1083009021
Name:ZIMMERMAN, JILL ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:ANN
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 PACHA PKWY
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-4831
Mailing Address - Country:US
Mailing Address - Phone:319-499-6006
Mailing Address - Fax:
Practice Address - Street 1:625 PACHA PKWY
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-4831
Practice Address - Country:US
Practice Address - Phone:319-499-6006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist