Individual
CHARLES PAUL ZAKUTANSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
9030 CLINE AVE, HIGHLAND, IN 46322-2204
(219) 750-9497
Mailing address
2025 CARDINAL DR, WHEATFIELD, IN 46392-7361
(219) 241-6945
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
71014116A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28245123A
INDIANA NURSING BOARD
IN
01
—
F04230288
AMERICAN ACADEMY OF NURSE PRACTITIONERS
—
Enumeration date
07/18/2023
Last updated
07/18/2023
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