Provider Demographics
NPI:1972528784
Name:ZORN, MEGHAN S (PA-C)
Entity type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:S
Last Name:ZORN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:729 ARAPEEN DRIVE
Mailing Address - Street 2:CAMT- NEUROLOGY CLINIC
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108
Mailing Address - Country:US
Mailing Address - Phone:801-587-9637
Mailing Address - Fax:801-587-8113
Practice Address - Street 1:729 ARAPEEN DRIVE
Practice Address - Street 2:CAMT- NEUROLOGY CLINIC
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108
Practice Address - Country:US
Practice Address - Phone:801-587-9637
Practice Address - Fax:801-587-8113
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT47565081206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTQ13423Medicare UPIN
UT005772202Medicare ID - Type Unspecified