Healthcare Provider Details

I. General information

NPI: 1265718639
Provider Name (Legal Business Name): TAFFY ANN ZOELLE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2011
Last Update Date: 08/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5885 SUNNYBROOK DR
SIOUX CITY IA
51106-4203
US

IV. Provider business mailing address

5885 SUNNYBROOK DR
SIOUX CITY IA
51106-4203
US

V. Phone/Fax

Practice location:
  • Phone: 712-266-2760
  • Fax: 712-266-2719
Mailing address:
  • Phone: 712-266-2760
  • Fax: 712-266-2719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA-102105
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: