Basic Information
Provider Information
NPI: 1952945859
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZORBACH
FirstName: BIANCA
MiddleName: LEANN
NamePrefix: DR.
NameSuffix:  
Credential: DNP, CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CORNELIUS
OtherFirstName: BIANCA
OtherMiddleName: LEANN
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 577 RICH MAR ST
Address2:  
City: WESTMINSTER
State: MD
PostalCode: 211589479
CountryCode: US
TelephoneNumber: 4432445144
FaxNumber:  
Practice Location
Address1: 515 FAIRMOUNT AVE STE 500
Address2:  
City: TOWSON
State: MD
PostalCode: 212868502
CountryCode: US
TelephoneNumber: 4104941662
FaxNumber: 4104941718
Other Information
ProviderEnumerationDate: 11/04/2019
LastUpdateDate: 11/04/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XR202311MDY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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