Provider Demographics
NPI:1396742821
Name:ZIMMERMAN, AMBER L (PA-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:L
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 W ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3782
Mailing Address - Country:US
Mailing Address - Phone:717-291-6911
Mailing Address - Fax:717-390-2564
Practice Address - Street 1:225 W ORANGE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3782
Practice Address - Country:US
Practice Address - Phone:717-291-6911
Practice Address - Fax:717-390-2564
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002984L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant