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General NPI Number Information
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NPI Number | 1265914360
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Entity Type | Individual
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Provider Name | JENNYLLE ZANZI FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 301 S WHITE ST
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City | WAKE FOREST
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State | NC
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Zip | 27587-2916
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Country | US
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Telephone | 786-344-2774
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Fax |
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Provider Business Mailing Address
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Address Line | 550 CALLANDALE LN
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City | DURHAM
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State | NC
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Zip | 27703-9810
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Country | US
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Telephone | 178-634-4277
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F08180387
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ZANZ-IFYBBC
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License Number State | NC
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