Healthcare Provider Details

I. General information

NPI: 1437862711
Provider Name (Legal Business Name): STEPHANIE ZUCCONI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2023
Last Update Date: 01/02/2023
Certification Date: 01/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 COMMERCE DR
HESSTON KS
67062-8938
US

IV. Provider business mailing address

116 MEADOW LN
HESSTON KS
67062-9155
US

V. Phone/Fax

Practice location:
  • Phone: 620-869-9986
  • Fax: 620-869-9046
Mailing address:
  • Phone: 620-217-0346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: