Healthcare Provider Details

I. General information

NPI: 1609864255
Provider Name (Legal Business Name): CARRIE LORENE VAN ZANT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARRIE LORENE DUNNE NP

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 MIAMISBURG CENTERVILLE RD
MIAMISBURG OH
45342-7615
US

IV. Provider business mailing address

5752 OAK CREEK TRL
DAYTON OH
45424-4088
US

V. Phone/Fax

Practice location:
  • Phone: 937-247-6757
  • Fax:
Mailing address:
  • Phone: 937-478-6341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN.CNP.09754
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: