Provider Demographics
NPI:1740034297
Name:NEXUS WOUND CONSULTANTS LLC
Entity type:Organization
Organization Name:NEXUS WOUND CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIEBLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-227-9226
Mailing Address - Street 1:PO BOX 29650
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85038-9650
Mailing Address - Country:US
Mailing Address - Phone:830-285-8882
Mailing Address - Fax:
Practice Address - Street 1:1555 W SHORELINE DR STE 100
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-9107
Practice Address - Country:US
Practice Address - Phone:830-285-8882
Practice Address - Fax:830-365-8018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty