Provider Demographics
NPI:1174825681
Name:ZAPATA, KELLY (LPN)
Entity Type:Individual
Prefix:MISS
First Name:KELLY
Middle Name:
Last Name:ZAPATA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 FAIRHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-2029
Mailing Address - Country:US
Mailing Address - Phone:513-284-8017
Mailing Address - Fax:
Practice Address - Street 1:463 FAIRHAVEN DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-2029
Practice Address - Country:US
Practice Address - Phone:513-284-8017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN120450164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse