Provider Demographics
NPI:1104336221
Name:ZWICK, REBECCA ANN (FNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:ZWICK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4143 N 16TH ST STE 5
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-5351
Mailing Address - Country:US
Mailing Address - Phone:602-517-0321
Mailing Address - Fax:602-532-7528
Practice Address - Street 1:4143 N 16TH ST STE 5
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-5351
Practice Address - Country:US
Practice Address - Phone:602-517-0321
Practice Address - Fax:602-532-7528
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN086667163W00000X
AZTAP10779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse