Healthcare Provider Details

I. General information

NPI: 1598069973
Provider Name (Legal Business Name): ZACHARY N WRIGHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2010
Last Update Date: 12/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 SHADY MORNING AVE
NORTH LAS VEGAS NV
89031-2531
US

IV. Provider business mailing address

317 SHADY MORNING AVE
NORTH LAS VEGAS NV
89031-2531
US

V. Phone/Fax

Practice location:
  • Phone: 702-353-7070
  • Fax: 702-649-0710
Mailing address:
  • Phone: 702-353-7070
  • Fax: 702-649-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: