Provider Demographics
NPI:1881808210
Name:BURNATH, ZIMMIE LYNN (LVN)
Entity type:Individual
Prefix:MRS
First Name:ZIMMIE
Middle Name:LYNN
Last Name:BURNATH
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4280 BEGONIA RD
Mailing Address - Street 2:
Mailing Address - City:PHELAN
Mailing Address - State:CA
Mailing Address - Zip Code:92371-6873
Mailing Address - Country:US
Mailing Address - Phone:760-868-3157
Mailing Address - Fax:
Practice Address - Street 1:13452 CABANA WAY
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-6376
Practice Address - Country:US
Practice Address - Phone:760-245-9608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN199984164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse