Provider Demographics
NPI:1841930872
Name:ZANABRIA, JESMYN SHIRLEY (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:JESMYN
Middle Name:SHIRLEY
Last Name:ZANABRIA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 28TH ST NW
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-6657
Mailing Address - Country:US
Mailing Address - Phone:253-273-3262
Mailing Address - Fax:
Practice Address - Street 1:1106 28TH ST NW
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-6657
Practice Address - Country:US
Practice Address - Phone:253-273-3262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61274847363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty