Provider Demographics
NPI:1629658026
Name:ZORZI, JENNA RENEE
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:RENEE
Last Name:ZORZI
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 1:7663 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4047
Mailing Address - Country:US
Mailing Address - Phone:330-770-7061
Mailing Address - Fax:
Practice Address - Street 1:935 TRAILWOOD DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-5062
Practice Address - Country:US
Practice Address - Phone:330-953-3204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-09
Last Update Date:2023-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF11200480363LF0000X
OHAPRN.CNP.0028765363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0439688Medicaid