Healthcare Provider Details

I. General information

NPI: 1831181221
Provider Name (Legal Business Name): CAROLYN SUE ZARA CRNP, CNS, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAROLYN SUE ZARA CRNP, CNS, IBCLC

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 STURGES AVE SUITE #2
MANSFIELD OH
44903-2399
US

IV. Provider business mailing address

120 STURGES AVE SUITE #2
MANSFIELD OH
44903-2399
US

V. Phone/Fax

Practice location:
  • Phone: 419-525-4620
  • Fax: 419-525-4620
Mailing address:
  • Phone: 419-525-4620
  • Fax: 419-525-4620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP-04736
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP-04736
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License NumberNS-04519
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code364SW0102X
TaxonomyWomen's Health Clinical Nurse Specialist
License NumberNS-04519
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: