Jill Renae Zimmermann, RN, IBCLC, PHN

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

R112787-2 Issued in MN

Practice address

9433 Parkside CT
Champlin, MN 55316-2604

Phone

(763) 486-8123

NPI assigned

Apr 29, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1335657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335657600000",
    "number": "1578821419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9433 PARKSIDE CT",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553162604",
            "telephone_number": "763-486-8123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9433 PARKSIDE CT",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553162604",
            "telephone_number": "763-486-8123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMANN",
        "first_name": "JILL",
        "middle_name": "RENAE",
        "name_prefix": "Ms.",
        "credential": "RN, IBCLC, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-29",
        "last_updated": "2012-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MN",
            "license": "R112787-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maita Yang, LICSW
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• Hamza Yusuf
• Anthony Zabel, O.D.
• Zeor Healthcare LLC
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• Lactation Consultant (Registered Nurse) in Champlin, MN
• Providers in Champlin, MN by specialty
• Lactation Consultant (Registered Nurse) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2012; 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.