Provider Demographics
NPI:1043496714
Name:ZDAN, PATRICIA K (RN, MSN, CCRN, APN-C)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:K
Last Name:ZDAN
Suffix:
Gender:F
Credentials:RN, MSN, CCRN, APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 806
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-0806
Mailing Address - Country:US
Mailing Address - Phone:732-360-9600
Mailing Address - Fax:732-360-9700
Practice Address - Street 1:499 MARLBORO RD
Practice Address - Street 2:SUITE 1
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3746
Practice Address - Country:US
Practice Address - Phone:732-360-9600
Practice Address - Fax:732-360-9700
Is Sole Proprietor?:No
Enumeration Date:2008-01-12
Last Update Date:2008-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO04994400363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NO04994400OtherSTATE LICENSE