Provider Demographics
NPI:1669628822
Name:ZAMBONI, ANGELINA MARIA (NP)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:MARIA
Last Name:ZAMBONI
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:PO BOX 5579
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97708-5579
Mailing Address - Country:US
Mailing Address - Phone:541-706-6623
Mailing Address - Fax:541-526-6626
Practice Address - Street 1:2275 NE DOCTORS DR STE 6
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6092
Practice Address - Country:US
Practice Address - Phone:541-706-2780
Practice Address - Fax:541-706-4806
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA814786163W00000X
OR201150051NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse