Melinda Zackowski, PA-C
Physician Assistant in Columbus, OH. Individual provider (NPI-1).
NPI number1407247828
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1407247828
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Melinda Zackowski
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 6, 2015
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 50005095RX | OH | Yes |
| 363A00000X | Physician Assistant | 0010-05583 | NC |
Other names
- Melinda Lackore (Former Name)
Practice location
5100 W Broad StColumbus, OH 43228-1607
Phone 614-544-1000
Mailing address
6036 Champions Crest DrCharlotte, NC 28269-6252
Phone 757-335-2227
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