Healthcare Provider Details

I. General information

NPI: 1053791483
Provider Name (Legal Business Name): JEFFREY ZAENGER CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4803 MONTGOMERY RD STE 120
CINCINNATI OH
45212-1153
US

IV. Provider business mailing address

237 WILLIAM HOWARD TAFT RD
CINCINNATI OH
45219-2610
US

V. Phone/Fax

Practice location:
  • Phone: 513-631-2474
  • Fax: 513-531-0862
Mailing address:
  • Phone: 513-351-9900
  • Fax: 513-366-4491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.17354-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: