Basic Information
Provider Information
NPI: 1376147140
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZINT
FirstName: PAIGE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1101 E 17TH ST UNIT 425
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462021840
CountryCode: US
TelephoneNumber: 8124314292
FaxNumber:  
Practice Location
Address1: 8111 S EMERSON AVE
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462378601
CountryCode: US
TelephoneNumber: 3175288148
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/23/2020
LastUpdateDate: 11/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X10003137AINY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


Home