Healthcare Provider Details

I. General information

NPI: 1356130827
Provider Name (Legal Business Name): ZACHARY QUINN PERSON FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5444 BURBANK DR
BATON ROUGE LA
70820-4011
US

IV. Provider business mailing address

706 SUMMER BREEZE DR
BATON ROUGE LA
70810-6187
US

V. Phone/Fax

Practice location:
  • Phone: 225-388-6630
  • Fax: 225-761-5702
Mailing address:
  • Phone: 337-550-5379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number208135
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: