Provider Demographics
NPI:1942674882
Name:HURT, ZACHARY RYAN (ND, LAC, RN, BSN)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:RYAN
Last Name:HURT
Suffix:
Gender:M
Credentials:ND, LAC, RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 5TH ST SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-3912
Mailing Address - Country:US
Mailing Address - Phone:864-554-7190
Mailing Address - Fax:
Practice Address - Street 1:708 5TH ST SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-3912
Practice Address - Country:US
Practice Address - Phone:864-554-7190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121001024171100000X
VA0001310221163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171100000XOther Service ProvidersAcupuncturist