Healthcare Provider Details

I. General information

NPI: 1902545262
Provider Name (Legal Business Name): ZOE K BEYER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ZOE KOPIN

II. Dates (important events)

Enumeration Date: 06/03/2022
Last Update Date: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 ELM AVE SE
ROANOKE VA
24013-2222
US

IV. Provider business mailing address

213 S JEFFERSON ST STE 1006
ROANOKE VA
24011-1713
US

V. Phone/Fax

Practice location:
  • Phone: 540-985-4099
  • Fax: 540-985-4069
Mailing address:
  • Phone: 540-224-5352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024184426
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: