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NPI Code Detail

MEDICARE: ZACHARY IAN EDWARDS CRNA

MEDICARE: ZACHARY IAN EDWARDS CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist1-083436IN
2367500000XCertified Registered Nurse Anesthetist1083436AL

General Provider Information

NPI Number : 1134178569
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY IAN EDWARDS CRNA
Provider Business Mailing Address
First Line : 2151 OLD ROCKY RIDGE RD
Second Line : SUITE 106
City : BIRMINGHAM
State : AL
Zip : 35216-7235
Country : US
Telephone Number : 205-989-1091
Fax Number : 205-989-1087
Provider Business Practice Location Address
First Line : 315 W HICKORY ST
Second Line :
City : SYLACAUGA
State : AL
Zip : 35150-2913
Country : US
Telephone Number : 256-401-4605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 03/18/2024

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Directions to “ ZACHARY IAN EDWARDS CRNA” Practice Location

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