Provider Demographics
NPI:1235461575
Name:ZGONC, KATHRYN ANNE (RN, BSN)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:ANNE
Last Name:ZGONC
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 COUNTY ROAD 150
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44654-8921
Mailing Address - Country:US
Mailing Address - Phone:330-414-2323
Mailing Address - Fax:
Practice Address - Street 1:1610 COUNTY ROAD 150
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:OH
Practice Address - Zip Code:44654-8921
Practice Address - Country:US
Practice Address - Phone:330-414-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH322660163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse