Provider Demographics
NPI:1588815690
Name:ZIMMERMAN, ANGELA LYNN (PMHNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LYNN
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:LYNN
Other - Last Name:MARLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7525 W 10TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-4493
Mailing Address - Country:US
Mailing Address - Phone:303-800-6364
Mailing Address - Fax:
Practice Address - Street 1:7525 W 10TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-4493
Practice Address - Country:US
Practice Address - Phone:303-800-6364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-99529-052163W00000X
CORN1618782163W00000X
COAPN.0998604-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse