Healthcare Provider Details

I. General information

NPI: 1790836682
Provider Name (Legal Business Name): DONNA ZAKEN N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WICKFORD CT
N KINGSTOWN RI
02852-5537
US

IV. Provider business mailing address

200 WICKFORD CT
N KINGSTOWN RI
02852-5537
US

V. Phone/Fax

Practice location:
  • Phone: 401-474-0238
  • Fax: 727-604-7656
Mailing address:
  • Phone: 401-474-0238
  • Fax: 727-604-7656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number304134
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: