Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 3014914 | KY |
NPI | 1013527837 |
---|---|
Provider Name | Dixie Lee Zimmerman |
First Address | Covington, KY 41011-3775 |
Second Address | Florence, KY 41042-1553 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2020 |
Last Update Date | 16/11/2021 |