Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 95015393 | CA |
NPI | 1497354484 |
---|---|
Provider Name | Ms. Laura Renee Zimmerman |
First Address | Fairfield, CA 94534-7541 |
Second Address | Palo Alto, CA 94304-1207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2020 |
Last Update Date | 21/10/2020 |