Healthcare Provider Details

I. General information

NPI: 1295606630
Provider Name (Legal Business Name): ALEXANDRA LAVONNE ZINN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 10/24/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6011 EUCLID AVE
EUCLID OH
44117
US

IV. Provider business mailing address

2424 ANTIOCH RD
PERRY OH
44081-9782
US

V. Phone/Fax

Practice location:
  • Phone: 855-967-2436
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number414030
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: