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General NPI Number Information
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NPI Number | 1669124848
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Entity Type | Individual
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Provider Name | ZACHARY SCOTT DRAWHON APRN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 5114 N GLEN PARK PLACE RD STE 110
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City | PEORIA
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State | IL
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Zip | 61614-4686
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Country | US
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Telephone | 309-683-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 10123 ARROW RD
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City | TREMONT
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State | IL
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Zip | 61568-9346
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Country | US
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Telephone | 309-242-4675
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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 | 209.024684
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License Number State | IL
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