Healthcare Provider Details

I. General information

NPI: 1598587875
Provider Name (Legal Business Name): MADELINE ZUMBRO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MADELINE FARRAR

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 OSPREY DR
WILLIAMSTOWN WV
26187-8555
US

IV. Provider business mailing address

85 KNOB CT
VINCENT OH
45784-5610
US

V. Phone/Fax

Practice location:
  • Phone: 304-865-5100
  • Fax:
Mailing address:
  • Phone: 740-350-4242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRNCNP0037980
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: