Provider Demographics
NPI:1104976323
Name:KING, ZOLA MCDANIELS (CRNA)
Entity type:Individual
Prefix:
First Name:ZOLA
Middle Name:MCDANIELS
Last Name:KING
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:NHRMC ANESTHESIA DEPT
Mailing Address - Street 2:2131 S. 17TH STREET
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7407
Mailing Address - Country:US
Mailing Address - Phone:910-343-7128
Mailing Address - Fax:910-772-9452
Practice Address - Street 1:2131 S 17TH ST
Practice Address - Street 2:NHRMC ANESTHESIA DEPT
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7407
Practice Address - Country:US
Practice Address - Phone:910-343-7128
Practice Address - Fax:910-772-9452
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC044096367500000X
NC1735367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC260628Medicare ID - Type Unspecified