Healthcare Provider Details

I. General information

NPI: 1497016984
Provider Name (Legal Business Name): ANTOINETTE ZAFFINO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 05/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6580 S 46TH ST
FRANKLIN WI
53132-8153
US

IV. Provider business mailing address

4961 N SANTA MONICA BLVD #3
WHITEFISH BAY WI
53217-5970
US

V. Phone/Fax

Practice location:
  • Phone: 414-421-0276
  • Fax:
Mailing address:
  • Phone: 414-573-9480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number127203-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: