Provider Demographics
NPI:1730482258
Name:ZIMBELMAN, BRANDI (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:
Last Name:ZIMBELMAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 SOUTH BLVD
Mailing Address - Street 2:STE C
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-2888
Mailing Address - Country:US
Mailing Address - Phone:608-844-0496
Mailing Address - Fax:616-326-9554
Practice Address - Street 1:515 SOUTH BLVD
Practice Address - Street 2:STE C
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-2888
Practice Address - Country:US
Practice Address - Phone:608-844-0496
Practice Address - Fax:616-326-9554
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129734363L00000X
NC222306363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1730482258Medicaid
NC1730482258Medicaid