Provider Demographics
NPI:1457817447
Name:WHITE, ZACHARY HUNTER LANE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:HUNTER LANE
Last Name:WHITE
Suffix:
Gender:M
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 9TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-4527
Mailing Address - Country:US
Mailing Address - Phone:205-481-7256
Mailing Address - Fax:
Practice Address - Street 1:995 9TH AVE SW
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-4527
Practice Address - Country:US
Practice Address - Phone:205-481-7256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-14
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-162898163W00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE