Provider Demographics
NPI:1740232586
Name:ZIMMERMAN, HEATHER LEIGH (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:LEIGH
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LEIGH
Other - Last Name:WASS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:555 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2136
Mailing Address - Country:US
Mailing Address - Phone:402-280-8100
Mailing Address - Fax:402-280-8103
Practice Address - Street 1:14080 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:BOYS TOWN
Practice Address - State:NE
Practice Address - Zip Code:68010-7513
Practice Address - Country:US
Practice Address - Phone:402-778-6900
Practice Address - Fax:402-778-6917
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE24218208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I53933Medicare UPIN