Provider Demographics
NPI:1699216127
Name:ZAPATA SAMAREL, LINA MARIA
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:MARIA
Last Name:ZAPATA SAMAREL
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 1:125 MARILYN PERRY LN
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-7565
Mailing Address - Country:US
Mailing Address - Phone:864-756-8199
Mailing Address - Fax:
Practice Address - Street 1:35 VILLAGE RD
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949-1234
Practice Address - Country:US
Practice Address - Phone:864-756-8199
Practice Address - Fax:864-343-8060
Is Sole Proprietor?:No
Enumeration Date:2017-03-16
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20844363LF0000X, 363LP0808X
OR10005321363LP0808X
MARN2378313363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily