Provider Demographics
NPI:1790821049
Name:ZIMMERMANN, JOANNA MAE (RN,BSN,PHN11)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:MAE
Last Name:ZIMMERMANN
Suffix:
Gender:F
Credentials:RN,BSN,PHN11
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 680 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96114
Mailing Address - Country:US
Mailing Address - Phone:530-253-1188
Mailing Address - Fax:
Practice Address - Street 1:1445 BUNYAN RD
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-3142
Practice Address - Country:US
Practice Address - Phone:530-251-8183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA519828163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health