Healthcare Provider Details

I. General information

NPI: 1487614004
Provider Name (Legal Business Name): ANNE M ZAPPACOSTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 LANDSDOWNE DR
ASHLAND KY
41102-5422
US

IV. Provider business mailing address

99 CRACKER BARREL DR STE 100
BARBOURSVILLE WV
25504-1650
US

V. Phone/Fax

Practice location:
  • Phone: 606-324-3005
  • Fax: 606-329-1530
Mailing address:
  • Phone: 304-525-7851
  • Fax: 304-525-1504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number19380
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number50928
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: