Basic Information
| Provider Information | |||||||||
| NPI: | 1366777500 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZIMNY | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | ANP-BC, AOCNS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 424 SAVANNAH RD | ||||||||
| Address2: | |||||||||
| City: | LEWES | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199581462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026453770 | ||||||||
| FaxNumber: | 3026455178 | ||||||||
| Practice Location | |||||||||
| Address1: | 4701 OGLETOWN-STANTON RD | ||||||||
| Address2: | SUITE 3400 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 19713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023661200 | ||||||||
| FaxNumber: | 3023661700 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2009 | ||||||||
| LastUpdateDate: | 03/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | LP-0010391 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.