Provider Demographics
NPI:1093191991
Name:PHILLIPS-BLANCHARD, ZOLA SUMMER
Entity Type:Individual
Prefix:
First Name:ZOLA
Middle Name:SUMMER
Last Name:PHILLIPS-BLANCHARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4170 BEXLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2711
Mailing Address - Country:US
Mailing Address - Phone:304-941-5799
Mailing Address - Fax:
Practice Address - Street 1:12213 REXFORD AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-2663
Practice Address - Country:US
Practice Address - Phone:216-200-6551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide