Healthcare Provider Details

I. General information

NPI: 1477011500
Provider Name (Legal Business Name): TIMOTHY GRAHAM ZAMULINSKI MSN, AGACNP-BC, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2019
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 CAMBRIDGE ST
KANSAS CITY KS
66160-8501
US

IV. Provider business mailing address

16252 FAYETTE ST
CONROE TX
77303-2010
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-1227
  • Fax:
Mailing address:
  • Phone: 979-450-5220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number53-84337
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: