Healthcare Provider Details

I. General information

NPI: 1932802097
Provider Name (Legal Business Name): MARISSA ZINGG APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARISSA LYNN ASHCRAFT

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 BEACON STREET SUITE 1E
BROOKLINE MA
02446-5587
US

IV. Provider business mailing address

4700 EXCHANGE COURT SUITE 110
BOCA RATON FL
33431-4450
US

V. Phone/Fax

Practice location:
  • Phone: 617-731-2390
  • Fax: 617-731-1283
Mailing address:
  • Phone: 617-731-2390
  • Fax: 617-731-1283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2300751
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: