Provider Demographics
NPI:1891913000
Name:WILLIAMS, ZINA MARIE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:ZINA
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:ZINA
Other - Middle Name:MARIE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:425 W GRAND AVE STE 3003
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-4722
Mailing Address - Country:US
Mailing Address - Phone:937-294-3603
Mailing Address - Fax:937-294-3612
Practice Address - Street 1:425 W GRAND AVE STE 3003
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-4722
Practice Address - Country:US
Practice Address - Phone:937-294-3603
Practice Address - Fax:937-294-3612
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN269995163WH0200X
OHAPRN.CNP.019822363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0191522Medicaid
OHH528660Medicare PIN