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Individual

DEBORAH WIMMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1035 W BERKS ST, PHILADELPHIA, PA 19122-1909
(215) 765-6690
(215) 765-6694
Mailing address
1035 W BERKS ST, PHILADELPHIA, PA 19122-1909
(610) 664-0280

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
VP000315D
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1014618380001
PA
01
1488081
AETNA
PA
01
1845164
BLUE CROSS
PA
01
2701047000
KEYSTONE HEALTH PLAN EAST
PA
01
30027031
KEYSTONE MERCY HEALTH PLAN
PA
Enumeration date
05/11/2006
Last updated
10/16/2008
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