Provider Demographics
NPI:1871725333
Name:ZONGO, DEBORAH KATHRYN (APRN, CNP)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:KATHRYN
Last Name:ZONGO
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:KATHRYN
Other - Last Name:JAHNKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP- BC
Mailing Address - Street 1:2386 CLOUD DR NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-5408
Mailing Address - Country:US
Mailing Address - Phone:651-325-8402
Mailing Address - Fax:
Practice Address - Street 1:4321 109TH AVE NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-6794
Practice Address - Country:US
Practice Address - Phone:763-726-9153
Practice Address - Fax:833-972-1581
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR160750-9363LF0000X
MN2705363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily