Provider Demographics
NPI:1700133121
Name:ZIMMERMAN, SAMANTHA LEIGH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:LEIGH
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:LEIGH
Other - Last Name:CONNERTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:604 STOCKDALE DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-5098
Mailing Address - Country:US
Mailing Address - Phone:610-823-5054
Mailing Address - Fax:
Practice Address - Street 1:604 STOCKDALE DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-5098
Practice Address - Country:US
Practice Address - Phone:610-823-5054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMC2701870363AM0700X
PAMA055582363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical