1730206137 NPI number — MRS. LYNN M ZIMMERMAN BS

Table of content: MRS. LYNN M ZIMMERMAN BS (NPI 1730206137)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730206137 NPI number — MRS. LYNN M ZIMMERMAN BS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZIMMERMAN
Provider First Name:
LYNN
Provider Middle Name:
M
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
BS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALBRECHT
Provider Other First Name:
LYNN
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
BS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730206137
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2055
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JAMESTOWN
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58402-2055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-253-6406
Provider Business Mailing Address Fax Number:
701-253-6400

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
520 3RD ST NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAMESTOWN
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58401-2968
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-253-6406
Provider Business Practice Location Address Fax Number:
701-253-6400
Provider Enumeration Date:
03/23/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)