Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | AP09854 | LA |
Y | 363LG0600X | Nurse Practitioner - Gerontology | AP09854 | LA |
NPI | 1023508041 |
---|---|
Provider Name | Brittany Michelle Zimmer |
First Address | Mandeville, LA 70448-3455 |
Second Address | Hammond, LA 70403-1436 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2018 |
Last Update Date | 09/07/2020 |