Brunson, Zachery M
Brunson, Zachery M is an individual health care provider with primary practice located at 393 E 2Nd N , Rexburg ID 83440. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Brunson, Zachery M can be contacted via phone (208) 356-5401.Contact Information
Primary practice address
393 E 2Nd N
Rexburg ID 83440
Phone: (208) 356-5401
Fax: (208) 356-3111
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA-607 | Idaho |
Profile Details
| NPI number | 1447296785 |
|---|---|
| LBN Legal business name | Brunson, Zachery M |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2006 |
| Last updated | Apr 13th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447296785 | NPPES |
| Idaho | MEDICAID | 807432900 |
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