Provider Demographics
NPI:1518755966
Name:VIELMA, ZANDRA
Entity type:Individual
Prefix:
First Name:ZANDRA
Middle Name:
Last Name:VIELMA
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 1:221 HERBSTER ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-4335
Mailing Address - Country:US
Mailing Address - Phone:567-280-7326
Mailing Address - Fax:567-280-7326
Practice Address - Street 1:221 HERBSTER ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-4335
Practice Address - Country:US
Practice Address - Phone:567-280-7326
Practice Address - Fax:567-280-7326
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant