Provider Demographics
NPI:1891039236
Name:ZIMMERMAN, BETTY WEBB (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:WEBB
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 944
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NC
Mailing Address - Zip Code:27830-0944
Mailing Address - Country:US
Mailing Address - Phone:919-242-6684
Mailing Address - Fax:
Practice Address - Street 1:204 COX BLVD
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534
Practice Address - Country:US
Practice Address - Phone:919-587-4128
Practice Address - Fax:919-731-6902
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201016363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily