Provider Demographics
NPI:1275017311
Name:ZARNELLO, LISA (FNP)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:ZARNELLO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-922-0553
Mailing Address - Fax:585-922-0496
Practice Address - Street 1:1637 HOWARD RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-2800
Practice Address - Country:US
Practice Address - Phone:585-429-9777
Practice Address - Fax:585-429-9774
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343610363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily