Provider Demographics
NPI:1285069591
Name:MAY, ZACHARY
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:MAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4319 MINNETONKA BLVD
Mailing Address - Street 2:#206
Mailing Address - City:SAINT LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4046
Mailing Address - Country:US
Mailing Address - Phone:952-200-6579
Mailing Address - Fax:
Practice Address - Street 1:2734 COUNTY ROAD D E
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-5624
Practice Address - Country:US
Practice Address - Phone:651-429-9891
Practice Address - Fax:651-330-5977
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide