Healthcare Provider Details

I. General information

NPI: 1619774627
Provider Name (Legal Business Name): AURELIO SILVEIRA ZABALETA RN, BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2908 10TH ST NW
ROANOKE VA
24012-4041
US

IV. Provider business mailing address

2908 10TH ST NW
ROANOKE VA
24012-4041
US

V. Phone/Fax

Practice location:
  • Phone: 540-520-5139
  • Fax:
Mailing address:
  • Phone: 540-520-5139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024197605
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number0001302908
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: