MEDICARE: VERONICA LEE ZOLLO ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	54855	OK

General Provider Information

NPI Number	:	1306155148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA LEE ZOLLO ARNP

Provider Business Mailing Address
First Line	:	14024 QUAIL POINTE DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-1006
Country	:	US
Telephone Number	:	405-419-8447
Fax Number	:

Provider Business Practice Location Address
First Line	:	3048 SW 89TH ST STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-6359
Country	:	US
Telephone Number	:	405-464-8819
Fax Number	:	405-692-6601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2010
Last Update Date	:	01/07/2016

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