Healthcare Provider Details

I. General information

NPI: 1255045092
Provider Name (Legal Business Name): ASHLEY PAULINE ZOLDAK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2023
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5412 COURSEVIEW DR STE 215
MASON OH
45040-2410
US

IV. Provider business mailing address

10085 DARROW RD
TWINSBURG OH
44087-1409
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 440-623-4829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0032927
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0032927
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: