Healthcare Provider Details

I. General information

NPI: 1437436391
Provider Name (Legal Business Name): GEORGINA ZUNIGA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2011
Last Update Date: 11/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 W SMOKE TREE RD
GILBERT AZ
85233-6905
US

IV. Provider business mailing address

302 W SMOKE TREE RD
GILBERT AZ
85233-6905
US

V. Phone/Fax

Practice location:
  • Phone: 480-917-0117
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN092835
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: