Healthcare Provider Details

I. General information

NPI: 1629668231
Provider Name (Legal Business Name): RYAN SEAN ZAPPIA RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: STEPHANIE RYAN ZAPPIA RN, BSN, CCRN, EMT-P

II. Dates (important events)

Enumeration Date: 01/19/2021
Last Update Date: 01/19/2021
Certification Date: 01/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CVS DR
WOONSOCKET RI
02895-6146
US

IV. Provider business mailing address

126 BOSTON AVE
BEAUMONT CA
92223-7534
US

V. Phone/Fax

Practice location:
  • Phone: 401-765-1500
  • Fax:
Mailing address:
  • Phone: 805-276-5227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number829695
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: