Provider Demographics
NPI:1447570452
Name:ZIMMERMAN, HOLLY H (MS, CGC)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:H
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N STATE ST
Mailing Address - Street 2:DIVISION OF MEDICAL GENETICS
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:601-815-4490
Mailing Address - Fax:601-984-1916
Practice Address - Street 1:2500 N STATE ST
Practice Address - Street 2:DIVISION OF MEDICAL GENETICS
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-815-4490
Practice Address - Fax:601-984-1916
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS