Provider Demographics
NPI:1992002885
Name:ZIMMERMAN, KIMBERLY R (RPH)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:R
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 RICHMOND CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-3125
Mailing Address - Country:US
Mailing Address - Phone:251-289-9466
Mailing Address - Fax:251-990-8760
Practice Address - Street 1:509 RICHMOND CIR
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-3125
Practice Address - Country:US
Practice Address - Phone:251-289-9466
Practice Address - Fax:251-990-8760
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist