Connie Jean Zimmerman, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

Practice address

C2442 Holstien Rd
Edgar, WI 54426-9317

Phone

(715) 352-2319

NPI assigned

Jan 10, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1356490957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C2442 HOLSTIEN RD",
            "city": "EDGAR",
            "state": "WI",
            "postal_code": "544269317",
            "telephone_number": "715-352-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "C2442 HOLSTIEN RD",
            "city": "EDGAR",
            "state": "WI",
            "postal_code": "544269317",
            "telephone_number": "715-352-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "CONNIE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3501110",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sport & Spine Clinic LP
• Taryn Lynne Stittleburg, DC
• Thomas G Stoffel, MD
• Szmanda Dental Center, SC
• Kim Woller, RN

• Home Health Registered Nurse in Edgar, WI
• Providers in Edgar, WI by specialty
• Home Health Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.