Healthcare Provider Details

I. General information

NPI: 1821214016
Provider Name (Legal Business Name): SHAUNA ZORNES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 02/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 HIGHWAY 414 NORTH
MOUNTAIN VIEW WY
82939
US

IV. Provider business mailing address

1332 SORENSON
KEMMERER WY
83101
US

V. Phone/Fax

Practice location:
  • Phone: 307-782-6601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-021
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: