Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 01060483 | IN |
NPI | 1104032614 |
---|---|
Provider Name | Dr. Jennifer Ann Zimmer |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5272 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 25/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200947250 | (05) | IN |