Provider Demographics
NPI:1790746808
Name:ZIMMERMAN, KAREN ANN (CNM, FNP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ANN
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:CNM, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 CEDAR ST SE
Mailing Address - Street 2:STE. 5640
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4917
Mailing Address - Country:US
Mailing Address - Phone:505-843-6168
Mailing Address - Fax:505-247-9743
Practice Address - Street 1:1825 WOODWINDS DRIVE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2298
Practice Address - Country:US
Practice Address - Phone:651-232-6700
Practice Address - Fax:505-890-5933
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMR42003363LF0000X
NM491367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM93725710Medicaid
NMNMA101488Medicare PIN