Provider Demographics
NPI:1144535642
Name:ZOOK, KATHRYN ANNE (NP, C)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANNE
Last Name:ZOOK
Suffix:
Gender:F
Credentials:NP, C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DAVIDSON COUNTY HEALTH DEPARTMENT
Mailing Address - Street 2:PO BOX 439
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27293-0439
Mailing Address - Country:US
Mailing Address - Phone:336-242-2300
Mailing Address - Fax:
Practice Address - Street 1:915 N GREENSBORO ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-2699
Practice Address - Country:US
Practice Address - Phone:336-242-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004819363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1694TOtherBLUECROSS BLUESHIELD NC
NC5371A247Medicaid