Provider Demographics
NPI:1891062337
Name:ZIRNA, KATHLEEN A (RN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:ZIRNA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 MASTEN AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-1727
Mailing Address - Country:US
Mailing Address - Phone:716-816-4213
Mailing Address - Fax:
Practice Address - Street 1:450 MASTEN AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-1727
Practice Address - Country:US
Practice Address - Phone:716-816-4213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390503-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse