Healthcare Provider Details

I. General information

NPI: 1407308000
Provider Name (Legal Business Name): JENNIFER ZAZZARINO MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2016
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4244 N 19TH AVE
PHOENIX AZ
85015-5108
US

IV. Provider business mailing address

DEPT. #394 P.O. BOX 1000
MEMPHIS TN
38148-0001
US

V. Phone/Fax

Practice location:
  • Phone: 602-661-0666
  • Fax: 480-564-3762
Mailing address:
  • Phone: 941-300-4440
  • Fax: 941-404-1760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP9601
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: