Healthcare Provider Details

I. General information

NPI: 1144916545
Provider Name (Legal Business Name): STEPHANIE ANN ZANARDELLI APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MADISON AVE
COVINGTON KY
41011-3313
US

IV. Provider business mailing address

215 E 11TH ST
NEWPORT KY
41071-2203
US

V. Phone/Fax

Practice location:
  • Phone: 859-655-6100
  • Fax: 859-655-6179
Mailing address:
  • Phone: 859-655-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP.0033006
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3017954
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: