Provider Demographics
NPI:1376062406
Name:ZAMORA, STEPHANIE MICHELE (FNP-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MICHELE
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 SANGAMORE RD STE N270
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2528
Mailing Address - Country:US
Mailing Address - Phone:240-507-5110
Mailing Address - Fax:844-682-8102
Practice Address - Street 1:4701 SANGAMORE RD STE N270
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-2528
Practice Address - Country:US
Practice Address - Phone:240-507-5110
Practice Address - Fax:844-682-8102
Is Sole Proprietor?:No
Enumeration Date:2017-09-09
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175159363LF0000X
MDR207751363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily