Provider Demographics
NPI:1811971385
Name:ZIMMERMAN, DORIS PAULINE (MSN RN CNS-BC LMFT)
Entity type:Individual
Prefix:MISS
First Name:DORIS
Middle Name:PAULINE
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MSN RN CNS-BC LMFT
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Mailing Address - Street 1:1801 LITITZ PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6522
Mailing Address - Country:US
Mailing Address - Phone:717-560-9060
Mailing Address - Fax:717-394-0505
Practice Address - Street 1:1801 LITITZ PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6522
Practice Address - Country:US
Practice Address - Phone:717-560-9060
Practice Address - Fax:717-394-0505
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2011-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMF000150106H00000X
PA14503901364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA072135Medicare ID - Type Unspecified
R05915Medicare UPIN