Provider Demographics
NPI:1962763292
Name:GONZALEZ, ZULMA I (LPN)
Entity type:Individual
Prefix:MRS
First Name:ZULMA
Middle Name:I
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8212 FALLEN MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1244
Mailing Address - Country:US
Mailing Address - Phone:423-503-6694
Mailing Address - Fax:
Practice Address - Street 1:8212 FALLEN MAPLE DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1244
Practice Address - Country:US
Practice Address - Phone:423-503-6694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN75302164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse