Provider Demographics
NPI:1083873244
Name:BROWN-ZIMMERMAN, SUSAN R (FNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:R
Last Name:BROWN-ZIMMERMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CASS ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3924
Mailing Address - Country:US
Mailing Address - Phone:781-979-9141
Mailing Address - Fax:
Practice Address - Street 1:ZERO CENTENIAL DRIVE
Practice Address - Street 2:CAB HEALTH AND RECOVERY
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960
Practice Address - Country:US
Practice Address - Phone:617-247-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA209071363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily