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: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10085 DARROW RD
TWINSBURG OH
44087-1409
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 Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0032927
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: