Healthcare Provider Details

I. General information

NPI: 1093165318
Provider Name (Legal Business Name): BRITTANY MORGAN ZIPPERLEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 CROSSLAKE PKWY
WACO TX
76712-6513
US

IV. Provider business mailing address

5424 LAKE HIGHLANDS DR
WACO TX
76710-2820
US

V. Phone/Fax

Practice location:
  • Phone: 254-420-2336
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2033
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA13057
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: