Healthcare Provider Details

I. General information

NPI: 1730179771
Provider Name (Legal Business Name): ZORICA BJELOVUK CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 09/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 HIGH STREET SUITE 200
WORTHINGTON OH
43085-4193
US

IV. Provider business mailing address

890 HIGH STREET SUITE 200
WORTHINGTON OH
43085-4193
US

V. Phone/Fax

Practice location:
  • Phone: 614-540-7339
  • Fax: 614-540-7338
Mailing address:
  • Phone: 614-540-7339
  • Fax: 614-540-7338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberCOA.04842.NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: