Provider Demographics
NPI:1821812454
Name:ZOMPARELLI, GIANNA GRACE (NP)
Entity type:Individual
Prefix:
First Name:GIANNA
Middle Name:GRACE
Last Name:ZOMPARELLI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 661
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-0661
Mailing Address - Country:US
Mailing Address - Phone:219-232-2772
Mailing Address - Fax:219-300-0020
Practice Address - Street 1:8247 WICKER AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOHN
Practice Address - State:IN
Practice Address - Zip Code:46373-8878
Practice Address - Country:US
Practice Address - Phone:219-232-2772
Practice Address - Fax:219-300-0020
Is Sole Proprietor?:No
Enumeration Date:2024-11-11
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28281846A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner