Provider Demographics
NPI:1770039448
Name:JONES, ZACKARY (CRNP)
Entity Type:Individual
Prefix:
First Name:ZACKARY
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 MCQUEEN SMITH RD N STE 302
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-7269
Mailing Address - Country:US
Mailing Address - Phone:334-361-7404
Mailing Address - Fax:334-361-7863
Practice Address - Street 1:645 MCQUEEN SMITH RD N STE 302
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-7269
Practice Address - Country:US
Practice Address - Phone:334-361-7404
Practice Address - Fax:334-361-7863
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-109527363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily