Provider Demographics
NPI:1447937446
Name:ZIMMERMAN-DUGGAN, ELIANA (CRNA)
Entity type:Individual
Prefix:
First Name:ELIANA
Middle Name:
Last Name:ZIMMERMAN-DUGGAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 WAVERLY ST APT B
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1342
Mailing Address - Country:US
Mailing Address - Phone:413-320-9903
Mailing Address - Fax:
Practice Address - Street 1:2031 WAVERLY ST APT B
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1342
Practice Address - Country:US
Practice Address - Phone:413-320-9903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2360368163WC0200X
MA153775367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine