Provider Demographics
NPI:1700573219
Name:CARRILLO, ZENYACE L (RN)
Entity Type:Individual
Prefix:
First Name:ZENYACE
Middle Name:L
Last Name:CARRILLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7761 HOLLYWOOD ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-1008
Mailing Address - Country:US
Mailing Address - Phone:303-416-0614
Mailing Address - Fax:
Practice Address - Street 1:938 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4028
Practice Address - Country:US
Practice Address - Phone:303-602-8986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1653489163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management