Provider Demographics
NPI:1730809054
Name:ZUCCALA, FRANK DAVID (FNP-BC)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:DAVID
Last Name:ZUCCALA
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7751
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-7751
Mailing Address - Country:US
Mailing Address - Phone:513-657-9771
Mailing Address - Fax:
Practice Address - Street 1:300 13TH ST W
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-5145
Practice Address - Country:US
Practice Address - Phone:406-265-3591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-197381363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner