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General NPI Number Information
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NPI Number | 1104887363
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Entity Type | Individual
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Provider Name | STEPHANIE A. ZANNIS NP
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Gender | Female
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1900 S HAWTHORNE RD SUITE 480-A (FORSYTH PEDIATRICS - MEDICAL PK)
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City | WINSTON-SALEM
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State | NC
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Zip | 27103-3913
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Country | US
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Telephone | 336-277-1600
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Fax | 336-277-1610
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Provider Business Mailing Address
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Address Line | 2000 FRONTIS PLAZA BLVD STE 200 (ATTN) FORSYTH MEDICAL GROUP
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City | WINSTON SALEM
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State | NC
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Zip | 27103-5616
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Country | US
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Telephone | 336-277-2435
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Fax | 336-277-9275
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 300368
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License Number State | NC
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