Individual
MRS. CARLA LYNN ZAVALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209010409
IL
363LA2200X
Adult Health Nurse Practitioner
277.000885
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041362928
MEDICAID
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
F400100472
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
05/03/2013
Last updated
04/10/2025
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