Healthcare Provider Details

I. General information

NPI: 1922138767
Provider Name (Legal Business Name): KERRI L ZUKOSKY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KERRI L HELD PA-C

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 11/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 INDIANA ST SUITE 390
GOLDEN CO
80401-5027
US

IV. Provider business mailing address

400 INDIANA ST SUITE 390
GOLDEN CO
80401-5027
US

V. Phone/Fax

Practice location:
  • Phone: 303-463-9600
  • Fax: 303-403-9919
Mailing address:
  • Phone: 303-463-9600
  • Fax: 303-403-9919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPAL-2139
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: