Provider Demographics
NPI:1801597117
Name:HELENTHAL, ZACKERY SCOTT (RN)
Entity type:Individual
Prefix:
First Name:ZACKERY
Middle Name:SCOTT
Last Name:HELENTHAL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 E PRENTICE AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2905
Mailing Address - Country:US
Mailing Address - Phone:303-835-8351
Mailing Address - Fax:
Practice Address - Street 1:8301 E PRENTICE AVE STE 210
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2905
Practice Address - Country:US
Practice Address - Phone:303-835-8351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1637111163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse