Healthcare Provider Details

I. General information

NPI: 1356284624
Provider Name (Legal Business Name): LAUREN ZOLLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 STATION RD APT 6302
BROOKFIELD CT
06804-1084
US

IV. Provider business mailing address

19 STATION RD APT 6302
BROOKFIELD CT
06804-1084
US

V. Phone/Fax

Practice location:
  • Phone: 603-793-1741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number076157-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: