Provider Demographics
NPI:1326213091
Name:ZACCAGNINO, JANINE RAE (ARNP)
Entity type:Individual
Prefix:MS
First Name:JANINE
Middle Name:RAE
Last Name:ZACCAGNINO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 3RD AVE W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8626
Mailing Address - Country:US
Mailing Address - Phone:941-708-9555
Mailing Address - Fax:
Practice Address - Street 1:200 3RD AVE W
Practice Address - Street 2:SUITE 100
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8626
Practice Address - Country:US
Practice Address - Phone:941-708-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2751842363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health