Provider Demographics
NPI:1124460373
Name:ZOBELL, ANNA L (NP-C)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:L
Last Name:ZOBELL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:L
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3345 POTOMAC WAY
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404
Mailing Address - Country:US
Mailing Address - Phone:208-552-6210
Mailing Address - Fax:208-552-2027
Practice Address - Street 1:3345 POTOMAC WAY
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404
Practice Address - Country:US
Practice Address - Phone:208-552-6210
Practice Address - Fax:208-552-2027
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-1356A363LF0000X
IDN-36973163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse