MEDICARE: STEPHANIE R ZOLLER MSDD, MSN, RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	0001257642	VA

General Provider Information

NPI Number	:	1134994122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE R ZOLLER MSDD, MSN, RN

Provider Business Mailing Address
First Line	:	7600 BEACH RD
Second Line	:
City	:	CHESTERFIELD
State	:	VA
Zip	:	23838-6513
Country	:	US
Telephone Number	:	804-481-1692
Fax Number	:

Provider Business Practice Location Address
First Line	:	7600 BEACH RD
Second Line	:
City	:	CHESTERFIELD
State	:	VA
Zip	:	23838-6513
Country	:	US
Telephone Number	:	804-481-1692
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2023
Last Update Date	:	03/16/2026

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