Provider Demographics
NPI:1942764139
Name:ZENO, ELIZABETH ROSE (RN, LSN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ROSE
Last Name:ZENO
Suffix:
Gender:F
Credentials:RN, LSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 W BROADWAY AVE
Mailing Address - Street 2:DAVIS CENTER - HEALTH SERVICES
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-2533
Mailing Address - Country:US
Mailing Address - Phone:612-668-0854
Mailing Address - Fax:612-668-0855
Practice Address - Street 1:1250 W BROADWAY AVE
Practice Address - Street 2:DAVIS CENTER - HEALTH SERVICES
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-2533
Practice Address - Country:US
Practice Address - Phone:612-668-0854
Practice Address - Fax:612-668-0855
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR115561-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool