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General NPI Number Information
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NPI Number | 1093583817
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Entity Type | Individual
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Provider Name | ZACHARY STEPHEN SEVIGNY
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Gender | Male
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 3073 WHITE MOUNTAIN HWY
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City | NORTH CONWAY
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State | NH
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Zip | 03860-7101
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Country | US
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Telephone | 603-356-5461
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Fax |
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Provider Business Mailing Address
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Address Line | 27 WASHINGTON ST STE 2A
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City | CONWAY
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State | NH
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Zip | 03818-6055
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Country | US
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Telephone | 603-307-8911
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 080407-23
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 080407-23
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License Number State | NH
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