Provider Demographics
NPI:1508689761
Name:ZINANIBE, ELIZABETH SOMALA-ANG (CNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SOMALA-ANG
Last Name:ZINANIBE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 RAAB ST
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-2084
Mailing Address - Country:US
Mailing Address - Phone:614-589-8671
Mailing Address - Fax:
Practice Address - Street 1:618 RAAB ST
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-2084
Practice Address - Country:US
Practice Address - Phone:614-589-8671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2024030557363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health