Healthcare Provider Details

I. General information

NPI: 1487729752
Provider Name (Legal Business Name): IRIS ZINK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IRIS IRIS ZINK NP

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4333 W ST JOE HWY
LANSING MI
48917-4100
US

IV. Provider business mailing address

4333 W ST JOE HWY
LANSING MI
48917-4100
US

V. Phone/Fax

Practice location:
  • Phone: 517-321-1525
  • Fax: 517-321-7059
Mailing address:
  • Phone: 517-321-1525
  • Fax: 517-321-7059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704205093
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: