Zimmerman-Deschepper, Tracy

Zimmerman-Deschepper, Tracy is an sole proprietor health care provider with primary practice located at 28 Nw 4Th Street Suite A, Grand Rapids MN 55744-2714. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Zimmerman-Deschepper, Tracy can be contacted via phone (218) 326-1274.

Contact Information

Primary practice address
28 Nw 4Th Street Suite A Grand Rapids MN 55744-2714
Phone: (218) 326-1274
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 2014011459 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X CNP3914 Minnesota

Profile Details

NPI number 1457753295
LBN Legal business name Zimmerman-Deschepper, Tracy
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 24th, 2014
Last updated May 25th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457753295 NPPES
Minnesota Other CO8154 MEDICARE PTAN
Minnesota Other 72560NO MEDICARE PTAN
Minnesota MEDICAID 894755400 MEDICARE PTAN

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