Provider Demographics
NPI:1861369209
Name:ZOSKY, HOLLY MARISA (RN)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:MARISA
Last Name:ZOSKY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:MARISA
Other - Last Name:GOODNOUGH-ZOSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:11303 OLD NORTON COEBURN RD
Mailing Address - Street 2:
Mailing Address - City:COEBURN
Mailing Address - State:VA
Mailing Address - Zip Code:24230-6507
Mailing Address - Country:US
Mailing Address - Phone:276-393-4810
Mailing Address - Fax:
Practice Address - Street 1:11303 OLD NORTON COEBURN RD
Practice Address - Street 2:
Practice Address - City:COEBURN
Practice Address - State:VA
Practice Address - Zip Code:24230-6507
Practice Address - Country:US
Practice Address - Phone:276-393-4810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001211382163WC0400X, 163WD0400X, 163WH0200X, 163WP0807X, 163WW0000X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WW0000XNursing Service ProvidersRegistered NurseWound Care