Provider Demographics
NPI:1225661200
Name:HASTINGS, ZACHARY DANE (RN)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:DANE
Last Name:HASTINGS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12701 WEST AVE APT 1333
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-1866
Mailing Address - Country:US
Mailing Address - Phone:210-355-6759
Mailing Address - Fax:
Practice Address - Street 1:12701 WEST AVE APT 1333
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-1866
Practice Address - Country:US
Practice Address - Phone:210-355-6759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX984387163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse