Provider Demographics
NPI:1972773547
Name:ZIMMERMAN, SARAH ANN (CNP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANN
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:ZIMMERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP
Mailing Address - Street 1:2285 BENDEN DR
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2568
Mailing Address - Country:US
Mailing Address - Phone:330-264-9029
Mailing Address - Fax:330-263-7251
Practice Address - Street 1:340 9TH ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-9470
Practice Address - Country:US
Practice Address - Phone:541-997-6085
Practice Address - Fax:541-902-9702
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2034101YM0800X
OH11857363LP0808X
OR201708493NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH11576416OtherCAQH