Provider Demographics
NPI:1528380839
Name:ZUKOWSKI, KELLY COX (KELLY ZUKOWSKI, ARNP)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:COX
Last Name:ZUKOWSKI
Suffix:
Gender:F
Credentials:KELLY ZUKOWSKI, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 HIGHWAY 441 N
Mailing Address - Street 2:SUITE A
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-1900
Mailing Address - Country:US
Mailing Address - Phone:863-763-5666
Mailing Address - Fax:863-763-5666
Practice Address - Street 1:1713 HIGHWAY 441 N
Practice Address - Street 2:SUITE A
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-1900
Practice Address - Country:US
Practice Address - Phone:863-763-5666
Practice Address - Fax:863-763-5666
Is Sole Proprietor?:No
Enumeration Date:2010-02-28
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9170246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily