Provider Demographics
NPI:1710596580
Name:PALUMBO, ZACHARY J (APRN)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:J
Last Name:PALUMBO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 N GRAND ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-3250
Mailing Address - Country:US
Mailing Address - Phone:620-249-8140
Mailing Address - Fax:
Practice Address - Street 1:302 E CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6564
Practice Address - Country:US
Practice Address - Phone:620-231-8003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-142454-102163WC0200X
MO2015018003163WC0200X
KS53-81355-102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine