Provider Demographics
NPI:1871959338
Name:ZIMMER, JULIE C (NP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:ZIMMER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:C
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4805 MONTGOMERY RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2198
Mailing Address - Country:US
Mailing Address - Phone:513-241-2370
Mailing Address - Fax:513-241-6053
Practice Address - Street 1:4805 MONTGOMERY RD
Practice Address - Street 2:SUITE 410
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2198
Practice Address - Country:US
Practice Address - Phone:513-241-2370
Practice Address - Fax:513-241-6053
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.18784-NP363LA2100X
OHAPRN.CNP.18784363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH369160Medicare PIN