Provider Demographics
NPI:1831582014
Name:ZEIGLER, NINA RICHELLE
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:RICHELLE
Last Name:ZEIGLER
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 1:2166 BOLERO DR
Mailing Address - Street 2:
Mailing Address - City:BAY POINT
Mailing Address - State:CA
Mailing Address - Zip Code:94565-7991
Mailing Address - Country:US
Mailing Address - Phone:510-677-5841
Mailing Address - Fax:
Practice Address - Street 1:2166 BOLERO DR
Practice Address - Street 2:
Practice Address - City:BAY POINT
Practice Address - State:CA
Practice Address - Zip Code:94565-7991
Practice Address - Country:US
Practice Address - Phone:510-677-5841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
#17OtherOTHER SERVICE PROVIDERS