Provider Demographics
NPI:1922138767
Name:ZUKOSKY, KERRI L (PA-C)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:L
Last Name:ZUKOSKY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:L
Other - Last Name:HELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:400 INDIANA ST
Mailing Address - Street 2:SUITE 390
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5027
Mailing Address - Country:US
Mailing Address - Phone:303-463-9600
Mailing Address - Fax:303-403-9919
Practice Address - Street 1:400 INDIANA ST
Practice Address - Street 2:SUITE 390
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5027
Practice Address - Country:US
Practice Address - Phone:303-463-9600
Practice Address - Fax:303-403-9919
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPAL-2139363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
017912OtherKAISER-COMMERCIAL NUMBER
COC1922138767Medicare PIN