Provider Demographics
NPI:1346466505
Name:ZIOMEK, ANN MARIE (RN)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:ZIOMEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1200 B GALE WILSON BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-3552
Mailing Address - Country:US
Mailing Address - Phone:707-864-5383
Mailing Address - Fax:707-399-2651
Practice Address - Street 1:1200 B GALE WILSON BLVD
Practice Address - Street 2:LINDA PRYOR, CORPORATE COMPLIANCE
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-3552
Practice Address - Country:US
Practice Address - Phone:707-864-5383
Practice Address - Fax:707-399-2651
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA546694163W00000X
CA1451163W00000X
CA11813363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACALIFORNIA RN LICENSOtherCALIFORNIA BRN