Healthcare Provider Details

I. General information

NPI: 1518231604
Provider Name (Legal Business Name): NINA MARIE ZIEMBA M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NINA MARIE DEPALMA M.S. CCC-SLP

II. Dates (important events)

Enumeration Date: 03/07/2012
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 S HUGHES ST
APEX NC
27502-7731
US

IV. Provider business mailing address

460 MAGDALA PL
APEX NC
27502-6686
US

V. Phone/Fax

Practice location:
  • Phone: 919-363-6117
  • Fax:
Mailing address:
  • Phone: 860-681-1099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202006407
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number10424
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: