Provider Demographics
NPI:1740995158
Name:ZALDIVAR, DAYLEN (APRN)
Entity type:Individual
Prefix:MR
First Name:DAYLEN
Middle Name:
Last Name:ZALDIVAR
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 JORDAN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-4495
Mailing Address - Country:US
Mailing Address - Phone:731-845-4813
Mailing Address - Fax:
Practice Address - Street 1:501 EASY ST
Practice Address - Street 2:
Practice Address - City:GODDARD
Practice Address - State:KS
Practice Address - Zip Code:67052-9211
Practice Address - Country:US
Practice Address - Phone:316-794-8635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-81834-022363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner