MEDICARE: JANE ZUCCOLILLO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	363A00000X	Physician Assistant	10491	AZ

General Provider Information

NPI Number	:	1295460020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE ZUCCOLILLO

Provider Business Mailing Address
First Line	:	PO BOX 3630
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86003-3630
Country	:	US
Telephone Number	:	928-522-9879
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 W UNIVERSITY AVE STE 101
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-2851
Country	:	US
Telephone Number	:	928-522-1300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2022
Last Update Date	:	08/22/2024

Similar Medicare Providers

1538016282 — EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
Practice Location Address:

1120 W UNIVERSITY AVE STE 101
FLAGSTAFF, AZ
86001-2851

Practice Phone: 520-670-3909
Practice Fax: 520-309-2560

1912290982 — STEVEN KENT OCHI D.O.
Practice Location Address:

1120 W UNIVERSITY AVE STE 101
FLAGSTAFF, AZ
86001-2851

Practice Phone: 928-522-1300
Practice Fax: 928-522-1301

1285136440 — ROBIN RACHELLE OSULLIVAN PSYD
Practice Location Address:

1120 W UNIVERSITY AVE
FLAGSTAFF, AZ
86001-2851

Practice Phone: 928-212-5761
Practice Fax:

1902364722 — MRS. HELEN E MCKINZIE LCSW
Practice Location Address:

1120 W UNIVERSITY AVE
FLAGSTAFF, AZ
86001-2851

Practice Phone: 928-522-1300
Practice Fax: 928-522-1300

1245821669 — JERRICA PARK PA-C
Practice Location Address:

1120 W UNIVERSITY AVE STE 101
FLAGSTAFF, AZ
86001-2851

Practice Phone: 928-522-1300
Practice Fax: 928-522-1301

1922707322 — MS. ASHLIE LARRIVA LPC
Practice Location Address:

1120 W UNIVERSITY AVE
FLAGSTAFF, AZ
86001-2851

Practice Phone: 928-522-1300
Practice Fax: 928-522-1301

Directions to “ JANE ZUCCOLILLO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.