Provider Demographics
NPI:1447066428
Name:ZIMBELMAN, BREANA
Entity type:Individual
Prefix:
First Name:BREANA
Middle Name:
Last Name:ZIMBELMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 MAIN ST S RM 106
Mailing Address - Street 2:
Mailing Address - City:TOWNER
Mailing Address - State:ND
Mailing Address - Zip Code:58788-4048
Mailing Address - Country:US
Mailing Address - Phone:701-537-5944
Mailing Address - Fax:701-537-5417
Practice Address - Street 1:407 MAIN ST S RM 106
Practice Address - Street 2:
Practice Address - City:TOWNER
Practice Address - State:ND
Practice Address - Zip Code:58788-4048
Practice Address - Country:US
Practice Address - Phone:701-537-5944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator