Provider Demographics
NPI:1447552153
Name:ZOKVIC, DOREEN LYNN (MS, RN, CNS, AGACNP)
Entity type:Individual
Prefix:MRS
First Name:DOREEN
Middle Name:LYNN
Last Name:ZOKVIC
Suffix:
Gender:F
Credentials:MS, RN, CNS, AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 S 169TH AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-7330
Mailing Address - Country:US
Mailing Address - Phone:219-776-6526
Mailing Address - Fax:
Practice Address - Street 1:287 E HUNT HWY STE 105
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-5096
Practice Address - Country:US
Practice Address - Phone:480-677-8282
Practice Address - Fax:480-535-0962
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003499A364SC0200X
IL209.021552363LA2100X
IL041.357664163W00000X
IN28151352A163W00000X
AZAP11096363LA2100X, 364SC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine
No163W00000XNursing Service ProvidersRegistered Nurse