Doctor Name: | ZACHARY HOLBERT |
NPI Number: | 1073985834 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP-BC |
License Number: | APRN82184-FNP-BC |
Business Practice Address: | 5008 Tipperary St Cross Lanes, WV - 253131525 |
Business Phone Number: | 3044007241 |
Business Fax Number: | |
Mailing Address: | 5008 Tipperary St, CROSS LANES |
State: | WV |
Postal Code: | 253131525 |
Phone Number: | 3044007241 |
Fax Number: | |
NPI Enumeration Date: | 10/20/2015 |
NPI Last Update Date: | 10/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | APRN82184-FNP-BC |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |