Healthcare Provider Details

I. General information

NPI: 1215690235
Provider Name (Legal Business Name): JILLIAN MARIE ZUCCO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2021
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COUNTY RD
MATTAPOISETT MA
02739-1584
US

IV. Provider business mailing address

200 MILL RD
FAIRHAVEN MA
02719-5252
US

V. Phone/Fax

Practice location:
  • Phone: 508-817-1860
  • Fax: 774-374-8074
Mailing address:
  • Phone: 508-973-2000
  • Fax: 508-973-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2310246
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: