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NPI Code Detail

MEDICARE: ZACHERY EDWARDS

MEDICARE: ZACHERY EDWARDS
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
1106S00000XBehavior TechnicianRBT-22-221646CO

General Provider Information

NPI Number : 1437943164
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHERY EDWARDS
Provider Business Mailing Address
First Line : 831 SEYMOUR LN
Second Line :
City : PAHRUMP
State : NV
Zip : 89048-4478
Country : US
Telephone Number : 775-990-2095
Fax Number :
Provider Business Practice Location Address
First Line : 1480 E CALVADA BLVD STE 900
Second Line :
City : PAHRUMP
State : NV
Zip : 89048-3962
Country : US
Telephone Number : 725-205-3628
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2025
Last Update Date : 04/07/2025

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Directions to “ ZACHERY EDWARDS ” Practice Location

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