Healthcare Provider Details

I. General information

NPI: 1811923253
Provider Name (Legal Business Name): DEBRA L ZEGLIN ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4535 DRESSLER RD NW
CANTON OH
44718-2545
US

IV. Provider business mailing address

PO BOX 418953
BOSTON MA
02241-8953
US

V. Phone/Fax

Practice location:
  • Phone: 800-828-0898
  • Fax: 330-493-8677
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR166279
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: