Provider Demographics
NPI:1275979767
Name:ZARRELLI, KIM (RN)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:ZARRELLI
Suffix:
Gender:F
Credentials:RN
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 6
Mailing Address - Street 2:
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-0006
Mailing Address - Country:US
Mailing Address - Phone:845-505-6724
Mailing Address - Fax:
Practice Address - Street 1:37 PRENTISS DR
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6014
Practice Address - Country:US
Practice Address - Phone:845-505-6724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-11
Last Update Date:2013-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY657320163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse