Provider Demographics
NPI:1992595136
Name:ZANT, INGE ELISABETH
Entity type:Individual
Prefix:
First Name:INGE
Middle Name:ELISABETH
Last Name:ZANT
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 1:1625 S SULLIVAN LN
Mailing Address - Street 2:
Mailing Address - City:CAMP VERDE
Mailing Address - State:AZ
Mailing Address - Zip Code:86322-6871
Mailing Address - Country:US
Mailing Address - Phone:928-274-4694
Mailing Address - Fax:
Practice Address - Street 1:1625 S SULLIVAN LN
Practice Address - Street 2:
Practice Address - City:CAMP VERDE
Practice Address - State:AZ
Practice Address - Zip Code:86322-6871
Practice Address - Country:US
Practice Address - Phone:928-274-4694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL10918H310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility