Provider Demographics
NPI:1992718134
Name:ZAMBROTTA, KAROLYN (CNM)
Entity type:Individual
Prefix:
First Name:KAROLYN
Middle Name:
Last Name:ZAMBROTTA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 FRIENDSHIP ST
Mailing Address - Street 2:SUITE220
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2272
Mailing Address - Country:US
Mailing Address - Phone:401-848-5556
Mailing Address - Fax:401-519-2994
Practice Address - Street 1:19 FRIENDSHIP ST
Practice Address - Street 2:SUITE 220
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-2272
Practice Address - Country:US
Practice Address - Phone:401-848-5556
Practice Address - Fax:401-519-2994
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMW00089367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0325040Medicaid
MARN0108Medicare ID - Type Unspecified