Provider Demographics
NPI:1477800431
Name:ZOLLMAN, KIMBERLY KAY (APRN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KAY
Last Name:ZOLLMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 A ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4299
Mailing Address - Country:US
Mailing Address - Phone:402-489-0800
Mailing Address - Fax:
Practice Address - Street 1:7001 A ST
Practice Address - Street 2:SUITE 110
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4299
Practice Address - Country:US
Practice Address - Phone:402-489-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111391163W00000X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47056474312Medicaid