Basic Information
| Provider Information | |||||||||
| NPI: | 1316957491 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZAMECNIK | ||||||||
| FirstName: | SUZANA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3803 SPRING ST | ||||||||
| Address2: | SUITE 410 | ||||||||
| City: | RACINE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 534051660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2626878260 | ||||||||
| FaxNumber: | 2626878729 | ||||||||
| Practice Location | |||||||||
| Address1: | 3803 SPRING ST | ||||||||
| Address2: | SUITE 410 | ||||||||
| City: | RACINE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 534051660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2626878260 | ||||||||
| FaxNumber: | 2626878729 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2006 | ||||||||
| LastUpdateDate: | 08/18/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 2540 | WI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.