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General NPI Number Information
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NPI Number | 1154991560
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Entity Type | Individual
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Provider Name | ZACHARY YATES LENNON AGACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 3480 WAKE FOREST RD
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City | RALEIGH
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State | NC
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Zip | 27609-7376
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Country | US
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Telephone | 919-684-4267
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Fax | 919-385-9791
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Provider Business Mailing Address
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Address Line | DUMC 3677
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City | DURHAM
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State | NC
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Zip | 27710-0001
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Country | US
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Telephone | 919-681-3421
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Fax | 919-681-1473
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 5014623
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License Number State | NC
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