Provider Demographics
NPI:1619582269
Name:ZAPATA, JOANNA GLORIAINEZ
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:GLORIAINEZ
Last Name:ZAPATA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 W ROCHELLE AVE APT 1029
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3900
Mailing Address - Country:US
Mailing Address - Phone:702-742-5194
Mailing Address - Fax:
Practice Address - Street 1:4201 W ROCHELLE AVE APT 1029
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-3900
Practice Address - Country:US
Practice Address - Phone:702-742-5194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2000718538Medicaid