Healthcare Provider Details

I. General information

NPI: 1861369209
Provider Name (Legal Business Name): HOLLY MARISA ZOSKY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HOLLY MARISA GOODNOUGH-ZOSKY RN

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11303 OLD NORTON COEBURN RD
COEBURN VA
24230-6507
US

IV. Provider business mailing address

11303 OLD NORTON COEBURN RD
COEBURN VA
24230-6507
US

V. Phone/Fax

Practice location:
  • Phone: 276-393-4810
  • Fax:
Mailing address:
  • Phone: 276-393-4810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number0001211382
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number0001211382
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number0001211382
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number0001211382
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number0001211382
License Number StateVA
# 6
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number0001211382
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: