Provider Demographics
NPI:1942766639
Name:ZEMO, JUSTIN RYAN (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:RYAN
Last Name:ZEMO
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MEDICAL CENTER DRIVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903
Mailing Address - Country:US
Mailing Address - Phone:256-456-0226
Mailing Address - Fax:256-456-0231
Practice Address - Street 1:300 MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 401
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903
Practice Address - Country:US
Practice Address - Phone:256-456-0226
Practice Address - Fax:256-456-0231
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-146363163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse