Provider Demographics
NPI:1396004321
Name:ZAPPONE, TABITHA (NP)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:
Last Name:ZAPPONE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 B TALISMAN DR. #3
Mailing Address - Street 2:
Mailing Address - City:PAGOSA SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81147
Mailing Address - Country:US
Mailing Address - Phone:970-731-5252
Mailing Address - Fax:970-731-5252
Practice Address - Street 1:27 B. TALISMAN DR. #3
Practice Address - Street 2:
Practice Address - City:PAGOSA SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81147
Practice Address - Country:US
Practice Address - Phone:970-731-5252
Practice Address - Fax:970-731-9922
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0990376-NP363LF0000X
CONP-990376363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO53831730Medicaid
CO53831730Medicaid
CO1336584879Medicare UPIN