Provider Demographics
NPI:1235651431
Name:MOTYKA, ZACHARY SMITH (FNP-C)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:SMITH
Last Name:MOTYKA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803
Mailing Address - Country:US
Mailing Address - Phone:540-713-4100
Mailing Address - Fax:540-713-4101
Practice Address - Street 1:13737 SPOTSWOOD TRL
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:VA
Practice Address - Zip Code:22827-3200
Practice Address - Country:US
Practice Address - Phone:540-713-4100
Practice Address - Fax:540-713-4101
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175042363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1235651431Medicaid