Provider Demographics
NPI:1265223630
Name:WIZZARD PANZIRONI, NATASHA
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:WIZZARD PANZIRONI
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 4TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-1113
Mailing Address - Country:US
Mailing Address - Phone:612-961-8147
Mailing Address - Fax:
Practice Address - Street 1:1903 4TH AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-1113
Practice Address - Country:US
Practice Address - Phone:612-961-8147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information