Provider Demographics
NPI:1689155137
Name:ZIMSKE, EMILY AMANDA (PA-C)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:AMANDA
Last Name:ZIMSKE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:AMANDA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:35 WINFIELD PLZ
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63389-3451
Mailing Address - Country:US
Mailing Address - Phone:636-668-6824
Mailing Address - Fax:
Practice Address - Street 1:35 WINFIELD PLZ
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:MO
Practice Address - Zip Code:63389-3451
Practice Address - Country:US
Practice Address - Phone:636-668-6824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024022605363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant