Provider Demographics
NPI:1730943200
Name:WILLIAMS, ZACHRY (APRN)
Entity type:Individual
Prefix:
First Name:ZACHRY
Middle Name:
Last Name:WILLIAMS
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 1:130 N D ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-4674
Mailing Address - Country:US
Mailing Address - Phone:334-590-0328
Mailing Address - Fax:
Practice Address - Street 1:4700 BAYOU BLVD STE 6
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-1901
Practice Address - Country:US
Practice Address - Phone:850-477-9253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11031053363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care