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General NPI Number Information
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NPI Number | 1235690538
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Entity Type | Individual
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Provider Name | MARIA JOHANA ZAMBRANO DO
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Gender | Female
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Dates
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Enumeration Date | 03/28/2019
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 2 PROFESSIONAL PARK DR STE 11
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6584
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Country | US
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Telephone | 423-952-6474
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 699
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City | MOUNTAIN HOME
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State | TN
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Zip | 37684-0699
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Country | US
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Telephone |
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Fax |
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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 | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 5873
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License Number State | TN
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