Provider Demographics
NPI:1023146016
Name:ZOELLNER, SUSAN SCOTT (RNFA)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:SCOTT
Last Name:ZOELLNER
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 HARDING AVE
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-6307
Mailing Address - Country:US
Mailing Address - Phone:408-358-1873
Mailing Address - Fax:408-358-3623
Practice Address - Street 1:240 HARDING AVE
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-6307
Practice Address - Country:US
Practice Address - Phone:408-358-1873
Practice Address - Fax:408-358-3623
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA367117364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical