Provider Demographics
NPI:1720588460
Name:ZAPATA, JAMIE NICHOLE
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:NICHOLE
Last Name:ZAPATA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:NICHOLE
Other - Last Name:GOSTNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:17207 FIRECREEK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-7126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17207 FIRECREEK RIDGE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-7126
Practice Address - Country:US
Practice Address - Phone:931-982-5431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX330945164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX40419449OtherDRIVER'S LICENSE