Provider Demographics
NPI:1598257271
Name:ZAHN, NICOLE L (DPM, MS)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:L
Last Name:ZAHN
Suffix:
Gender:F
Credentials:DPM, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5167 NW 48TH AVE
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4904
Mailing Address - Country:US
Mailing Address - Phone:954-234-1670
Mailing Address - Fax:
Practice Address - Street 1:1601 CLINT MOORE RD STE 180
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-5713
Practice Address - Country:US
Practice Address - Phone:561-929-0229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN911213E00000X
FLPO4155213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist