MEDICARE: HOLLY DOGGETT ZASTUDIL CNP

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	363LF0000X	Family Nurse Practitioner	COA.16353-NP	OH

General Provider Information

NPI Number	:	1659775088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY DOGGETT ZASTUDIL CNP

Provider Business Mailing Address
First Line	:	7470 SAWMILL RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235
Country	:	US
Telephone Number	:	614-889-8662
Fax Number	:

Provider Business Practice Location Address
First Line	:	7470 SAWMILL RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43235
Country	:	US
Telephone Number	:	614-889-8662
Fax Number	:

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

Provider Enumeration Date	:	10/14/2014
Last Update Date	:	04/09/2021

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