Individual
MADOLYNNE ZIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
389 CONGRESS ST, RM 307, PORTLAND, ME 04101-3509
(207) 874-8784
Mailing address
389 CONGRESS ST, RM 307, PORTLAND, ME 04101-3509
(207) 874-8784
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R024186
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3163434
AETNA
ME
01
—
39359
HARVARD PILGRIM
ME
01
—
M2048200
CIGNA
ME
Enumeration date
03/22/2007
Last updated
07/09/2007
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