Provider Demographics
NPI:1821773854
Name:ZINN, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:ZINN
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 1:114 E ROSEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22301-2326
Mailing Address - Country:US
Mailing Address - Phone:734-834-0008
Mailing Address - Fax:
Practice Address - Street 1:6355 WALKER LN STE 401
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3250
Practice Address - Country:US
Practice Address - Phone:703-924-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant