Healthcare Provider Details

I. General information

NPI: 1225428626
Provider Name (Legal Business Name): ELIZABETH ANN ZINNI FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2015
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 E MAIN ST
CANFIELD OH
44406-1541
US

IV. Provider business mailing address

540 E MAIN ST
CANFIELD OH
44406-1541
US

V. Phone/Fax

Practice location:
  • Phone: 330-533-3351
  • Fax: 330-533-8966
Mailing address:
  • Phone: 330-533-3351
  • Fax: 330-533-8966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.17018-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: