Provider Demographics
NPI:1154481547
Name:ZEMEK, DANIEL J
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:ZEMEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 IMPERIAL RDG
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4811
Mailing Address - Country:US
Mailing Address - Phone:505-647-7642
Mailing Address - Fax:505-647-7630
Practice Address - Street 1:1809 IMPERIAL RDG
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4811
Practice Address - Country:US
Practice Address - Phone:505-647-7642
Practice Address - Fax:505-647-7630
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR37709163W00000X
NMCNP00824363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse