Healthcare Provider Details

I. General information

NPI: 1053024182
Provider Name (Legal Business Name): ZEINAB HASSAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2023
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3512 STELLHORN RD
FORT WAYNE IN
46815-4631
US

IV. Provider business mailing address

PO BOX 392552
PITTSBURGH PA
15251-9552
US

V. Phone/Fax

Practice location:
  • Phone: 260-483-9081
  • Fax: 260-483-9196
Mailing address:
  • Phone: 512-792-4402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number28275072A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number71013456A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: