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NPI Code Detail

MEDICARE: KIMBERLY MICHELLE ZELASKO APRN, PMHNP

MEDICARE: KIMBERLY MICHELLE ZELASKO APRN, PMHNP
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
1163W00000XRegistered Nurse363810OH
2163WH0200XHome Health Registered Nurse363810OH
3363LP0808XPsychiatric/Mental Health Nurse Practitioner0033029OH

General Provider Information

NPI Number : 1871847558
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY MICHELLE ZELASKO APRN, PMHNP
Provider Business Mailing Address
First Line : 29 W NORTH BROADWAY ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43214-4015
Country : US
Telephone Number : 614-477-0514
Fax Number :
Provider Business Practice Location Address
First Line : 59 GRANT ST
Second Line :
City : NEWARK
State : OH
Zip : 43055-3939
Country : US
Telephone Number : 740-404-3446
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2012
Last Update Date : 11/05/2024

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