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General NPI Number Information
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NPI Number | 1003657784
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Entity Type | Individual
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Provider Name | ZACHARIAS PAUL PHELPS-ROPER RN
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Gender | Male
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 01/04/2026
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Provider Practice Location Address
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Address Line | 2811 TIETON DR
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City | YAKIMA
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State | WA
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Zip | 98902-3799
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Country | US
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Telephone | 509-575-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 W SAN ANGELO ST APT 1165
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City | GILBERT
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State | AZ
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Zip | 85233-2266
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Country | US
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Telephone | 785-250-0658
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 232348
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License Number State | AZ
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