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NPI Code Detail

MEDICARE: GAIL J. ZACOK FNP

MEDICARE:   GAIL J. ZACOK  FNP
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
1363LF0000XFamily Nurse PractitionerAPRN002188NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00419081OTHERMORR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255405148
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAIL J. ZACOK FNP
Provider Business Mailing Address
First Line : 4505 S MARYLAND PKWY
Second Line : BOX 453020
City : LAS VEGAS
State : NV
Zip : 89154-9900
Country : US
Telephone Number : 702-895-4337
Fax Number :
Provider Business Practice Location Address
First Line : 4505 S MARYLAND PKWY
Second Line : BOX 453020
City : LAS VEGAS
State : NV
Zip : 89154-9900
Country : US
Telephone Number : 702-895-3370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2006
Last Update Date : 08/06/2016

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Directions to “ GAIL J. ZACOK FNP” Practice Location

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