Healthcare Provider Details

I. General information

NPI: 1255044988
Provider Name (Legal Business Name): ZACHARY MICHAEL EMERSON BARBOUR CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2022
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HADDON AVE FL 3
CAMDEN NJ
08103-3101
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-988-6260
  • Fax: 856-988-6270
Mailing address:
  • Phone: 856-988-6260
  • Fax: 856-988-6270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN.1001968-CRNA
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR23207700
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NJ01446600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: