Provider Demographics
NPI:1760559157
Name:ZACHARY STRONGE, DEBRA A (NP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:ZACHARY STRONGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13510 W PERSIMMON LANE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13510 W PERSIMMON LANE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713
Practice Address - Country:US
Practice Address - Phone:661-588-6560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID34168363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9474OtherBOARD OF REGISTERED NURSING- NURSE PRACTITIONER FURNISHING
CA466812OtherBOARD OF REGISTERED NURSING- REGISTERED NURSE LICENSE
CA9474OtherBOARD OF REGISTERED NURSING- NURSE PRACTITIONER FURNISHING