MEDICARE: MS. KRISTINE ZNNE ZIEGLER

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	171M00000X	Case Manager/Care Coordinator		FL

General Provider Information

NPI Number	:	1962601401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTINE ZNNE ZIEGLER

Provider Business Mailing Address
First Line	:	501 SW BAILEY TER
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-2918
Country	:	US
Telephone Number	:	772-344-0674
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 SW BAILEY TER
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-2918
Country	:	US
Telephone Number	:	772-344-0674
Fax Number	:

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

Provider Enumeration Date	:	07/14/2007
Last Update Date	:	07/14/2007

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