Provider Demographics
NPI:1386077733
Name:ZHUKOVA, OLENA (ARNP)
Entity type:Individual
Prefix:
First Name:OLENA
Middle Name:
Last Name:ZHUKOVA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3488 E LAKE RD STE 403
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-2404
Mailing Address - Country:US
Mailing Address - Phone:813-872-4492
Mailing Address - Fax:813-870-1502
Practice Address - Street 1:3488 E LAKE RD STE 403
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-2404
Practice Address - Country:US
Practice Address - Phone:813-872-4492
Practice Address - Fax:813-870-1502
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9243501363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner