Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | DR.0054948 | CO |
N | 2080P0204X | Pediatric Emergency Doctor | 9895 | NV |
N | 2080P0204X | Pediatric Emergency Doctor | DR.0054948 | CO |
NPI | 1780669390 |
---|---|
Provider Name | Kimberly R. Zimmerman |
First Address | Denver, CO 80217-3862 |
Second Address | Denver, CO 80218-1235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 10/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A453340 | (05) | CA |
930120259 | RR MEDICARE (01) | CA |
96227371 | (05) | CO |
E97825 | (02) | NV |