Individual
DR. JILL ANNEMARIE ZACKRISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2004 BREMO RD STE 100, RICHMOND, VA 23226-2442
(804) 442-7794
(804) 767-2030
Mailing address
2004 BREMO RD STE 100, RICHMOND, VA 23226-2442
(804) 442-7794
(804) 767-2030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101254457
VA
207Q00000X
Family Medicine Physician
2012-00268
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
01
—
C09633
GROUP PTAN
VA
Enumeration date
05/21/2009
Last updated
03/24/2017
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