Provider Demographics
NPI:1255616801
Name:SWENSON ZIEBELL, SHERRY P (ARNP)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:P
Last Name:SWENSON ZIEBELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4355 BEAR GULLY RD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-9422
Mailing Address - Country:US
Mailing Address - Phone:321-282-0561
Mailing Address - Fax:
Practice Address - Street 1:4355 BEAR GULLY RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9422
Practice Address - Country:US
Practice Address - Phone:321-282-0561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 957062363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 957062OtherMEDICAL LICENSE