Provider Demographics
NPI:1699773762
Name:ZEH, MARY ANNE (APRN)
Entity type:Individual
Prefix:
First Name:MARY ANNE
Middle Name:
Last Name:ZEH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 320
Mailing Address - Street 2:
Mailing Address - City:THOMPSON
Mailing Address - State:CT
Mailing Address - Zip Code:06277-0320
Mailing Address - Country:US
Mailing Address - Phone:860-649-4477
Mailing Address - Fax:860-649-4470
Practice Address - Street 1:935 MAIN ST
Practice Address - Street 2:SUITE C2
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-6050
Practice Address - Country:US
Practice Address - Phone:860-649-4477
Practice Address - Fax:860-649-4470
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2020-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001682363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT165718OtherVALUE OPTIONS
0615345420004OtherCIGNA BEHAVIORAL HEALTH
CT211897000OtherMAGELLAN
CT400001682CT01OtherANTHEM
CT890000240Medicare UPIN