Healthcare Provider Details

I. General information

NPI: 1700300886
Provider Name (Legal Business Name): JILLIAN MARIE ZEMBOWER MSN, RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JILLIAN MALANDRO

II. Dates (important events)

Enumeration Date: 07/31/2017
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 BELMONT AVE FL 2
YOUNGSTOWN OH
44504-1006
US

IV. Provider business mailing address

1044 BELMONT AVE FL 2
YOUNGSTOWN OH
44504-1006
US

V. Phone/Fax

Practice location:
  • Phone: 330-480-3990
  • Fax: 330-480-3522
Mailing address:
  • Phone: 330-480-3990
  • Fax: 330-480-3522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.021378
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number021378
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: