Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 001357 | CT |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 001357 | CT |
NPI | 1487665089 |
---|---|
Provider Name | Holly M Zimmerman |
First Address | Hartford, CT 06102-8000 |
Second Address | Hartford, CT 06102-8000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 14/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004013579 | (05) | CT |
S54586 | (02) | CT |