DEBORAH WIMMER


Address: 1035 W Berks St, Philadelphia, PA 19122-1909
Phone: 2157656690

DEBORAH WIMMER (NPI# 1588614267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588614267
Entity Type Individual
Full Name DEBORAH WIMMER
Credential CRNP
Practice Address 1035 W Berks St
Philadelphia
PA 19122-1909
Practice Telephone 2157656690
Practice Fax Number 2157656694
Mailing Telephone 6106640280
Enumeration Date 2006-05-11
Last Update Date 2008-10-16
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
VP000315D PA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
PA 1014618380001 05
PA AETNA 1488081 01
PA KEYSTONE MERCY HEALTH PLAN 30027031 01
PA KEYSTONE HEALTH PLAN EAST 2701047000 01
PA BLUE CROSS 1845164 01

Office Location

Street Address 1035 W BERKS ST
City PHILADELPHIA
State PA
Zip Code 19122-1909

Providers in the same location

NPI Name Taxonomy Address Enumeration
1568427409 Donna L Brian Nurse Practitioner 1035 W Berks St, Philadelphia, PA 19122-1909 2006-04-20
1952555997 Karen E Walker Nurse Practitioner 1035 W Berks St, Philadelphia, PA 19122-1909 2008-11-04
1194822155 Public Health Management Corp Clinic/Center 1035 W Berks St, Philadelphia, PA 19122-1909 2006-09-20

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Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

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Competitor

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City PHILADELPHIA
Zip Code 19122

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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