Individual
MR. KENNETH E ZIMMERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
66 CLUB RD STE 360, EUGENE, OR 97401-2463
(541) 912-1295
(541) 972-8779
Mailing address
66 CLUB RD STE 360, EUGENE, OR 97401-2463
(541) 912-1295
(541) 972-8779
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
008004600N6
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
08004600RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500753024
—
OR
Enumeration date
01/18/2007
Last updated
06/26/2024
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