Provider Demographics
NPI:1760729438
Name:ZIMMERMAN, ELSIE W (MSN, NNP, B-C)
Entity Type:Individual
Prefix:
First Name:ELSIE
Middle Name:W
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MSN, NNP, B-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3485 ROTHSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-8757
Mailing Address - Country:US
Mailing Address - Phone:717-733-7457
Mailing Address - Fax:
Practice Address - Street 1:1800 ORLEANS ST
Practice Address - Street 2:SUITE 8391
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0010
Practice Address - Country:US
Practice Address - Phone:410-955-5255
Practice Address - Fax:443-287-9447
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010777363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal