Organization
NORTHEAST MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER LYNN ZOBA CRNA (NURSE ANESTHETIST)
(704) 783-1622
Entity
Organization
Contact information
Practice address
920 CHURCH ST, CONCORD, NC 28075
(704) 783-1622
Mailing address
12729 KANE ALEXANDER DR, HUNTERSVILLE, NC 28078-3775
(704) 992-0527
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
173393
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051934
—
NC
Enumeration date
07/26/2006
Last updated
08/22/2020
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