Provider Demographics
NPI:1861630097
Name:ZIMON, TERRI A ZIMON A (ANP)
Entity Type:Individual
Prefix:MRS
First Name:TERRI A ZIMON
Middle Name:A
Last Name:ZIMON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9377 N US HIGHWAY 301
Mailing Address - Street 2:
Mailing Address - City:WHITAKERS
Mailing Address - State:NC
Mailing Address - Zip Code:27891-8621
Mailing Address - Country:US
Mailing Address - Phone:503-215-4394
Mailing Address - Fax:
Practice Address - Street 1:9377 N US HIGHWAY 301
Practice Address - Street 2:
Practice Address - City:WHITAKERS
Practice Address - State:NC
Practice Address - Zip Code:27891-8621
Practice Address - Country:US
Practice Address - Phone:503-215-4394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-26
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR098006717N3 ANP-PP363LA2200X
WAAP30007370363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health