Provider Demographics
NPI:1376148809
Name:ZIMMER, CASSANDRA NICOLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:NICOLE
Last Name:ZIMMER
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 1:7316 HORN TAVERN CT
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37062-7254
Mailing Address - Country:US
Mailing Address - Phone:812-632-8225
Mailing Address - Fax:
Practice Address - Street 1:8110 HIGHWAY 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:TN
Practice Address - Zip Code:37221-4214
Practice Address - Country:US
Practice Address - Phone:999-999-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN55313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist