Provider Demographics
NPI:1790104776
Name:ZOK, BEATRICE NYAMUSI SR
Entity Type:Individual
Prefix:MRS
First Name:BEATRICE
Middle Name:NYAMUSI
Last Name:ZOK
Suffix:SR
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:BEATRICE
Other - Middle Name:NYAMUSI
Other - Last Name:ZOK
Other - Suffix:SR
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:340 CONCORD DR
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-1704
Mailing Address - Country:US
Mailing Address - Phone:408-915-9035
Mailing Address - Fax:
Practice Address - Street 1:340 CONCORD DR
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-1704
Practice Address - Country:US
Practice Address - Phone:408-915-9035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI316538-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse