Provider Demographics
NPI:1710426929
Name:ZIEBOLD, MAGGIE JOYCE (FNP)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:JOYCE
Last Name:ZIEBOLD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:JOYCE
Other - Last Name:MCLAUGHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:161 TULANE RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1628
Mailing Address - Country:US
Mailing Address - Phone:716-946-5393
Mailing Address - Fax:
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-21
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF341098363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner