Provider Demographics
NPI:1093768103
Name:ZORN, DONNA (LPT)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
Last Name:ZORN
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15294
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28813-0294
Mailing Address - Country:US
Mailing Address - Phone:828-665-0442
Mailing Address - Fax:828-665-0412
Practice Address - Street 1:1025 BREVARD RD
Practice Address - Street 2:SUITE 3
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-8562
Practice Address - Country:US
Practice Address - Phone:828-665-0442
Practice Address - Fax:828-665-0412
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4183174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC079AFOtherBC/BS
NC2504618Medicare PIN