Jena Zimmerman, CMF
Individual provider Active NPI Mastectomy Fitter · Ponca, NE
NPI 1942695960 · NPPES record last updated Apr 6, 2015
Key facts
- NPI
- 1942695960
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mastectomy Fitter 224900000X
- Practice address
- 401 Prairie Ave
Ponca, NE 68770-7319 - Phone
- (712) 259-0836
- NPI assigned
- Apr 6, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mastectomy Fitter | 224900000X | Yes |
Addresses
Primary practice location
401 Prairie Ave
Ponca, NE 68770-7319
Mailing address
401 Prairie Ave
Ponca, NE 68770-7319
Phone (712) 259-0836
Other providers in Ponca, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.