Provider Demographics
NPI:1720860315
Name:NORTON, ZACHARY STEWART (PMHNP)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:STEWART
Last Name:NORTON
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 IOWA DR
Mailing Address - Street 2:
Mailing Address - City:LE CLAIRE
Mailing Address - State:IA
Mailing Address - Zip Code:52753-9592
Mailing Address - Country:US
Mailing Address - Phone:309-230-9589
Mailing Address - Fax:
Practice Address - Street 1:1208 IOWA DR
Practice Address - Street 2:
Practice Address - City:LE CLAIRE
Practice Address - State:IA
Practice Address - Zip Code:52753-9592
Practice Address - Country:US
Practice Address - Phone:309-230-9589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG176425363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health