Provider Demographics
NPI:1437528411
Name:ZIMBA, DUMILE
Entity Type:Individual
Prefix:
First Name:DUMILE
Middle Name:
Last Name:ZIMBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11488 ALICIAS CT
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-4042
Mailing Address - Country:US
Mailing Address - Phone:678-463-8225
Mailing Address - Fax:
Practice Address - Street 1:11488 ALICIAS CT
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-4042
Practice Address - Country:US
Practice Address - Phone:678-463-8225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-19
Last Update Date:2015-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN091170164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse