MEDICARE: REBECCA ZAMBITO NP

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	AP30006177	WA

General Provider Information

NPI Number	:	1568494334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA ZAMBITO NP

Provider Business Mailing Address
First Line	:	PO BOX 984
Second Line	:
City	:	FORSYTH
State	:	MT
Zip	:	59327-0984
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	473 N 5TH AVE
Second Line	:
City	:	FORSYTH
State	:	MT
Zip	:	59327-9006
Country	:	US
Telephone Number	:	360-457-5139
Fax Number	:	360-841-7055

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	12/16/2022

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