Provider Demographics
NPI:1972988327
Name:ZIKOSKY, KAREN (CRNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:ZIKOSKY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:PISANCHYN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:743 JEFFERSON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1638
Mailing Address - Country:US
Mailing Address - Phone:570-207-7500
Mailing Address - Fax:570-207-3867
Practice Address - Street 1:743 JEFFERSON AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1639
Practice Address - Country:US
Practice Address - Phone:570-558-0182
Practice Address - Fax:570-558-0183
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP01533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028977480001Medicaid
PA1028977480001Medicaid