Provider Demographics
NPI:1154991560
Name:LENNON, ZACHARY YATES (AGACNP-BC)
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:YATES
Last Name:LENNON
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:DUMC 3677
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-681-3421
Mailing Address - Fax:919-681-1473
Practice Address - Street 1:3480 WAKE FOREST RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7376
Practice Address - Country:US
Practice Address - Phone:919-684-4267
Practice Address - Fax:919-385-9791
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5014623363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care