Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | 21573 | CA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 21573 | CA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 5013959 | NC |
NPI | 1184987042 |
---|---|
Provider Name | Zachary S Lo |
First Address | Cary, NC 27513-8158 |
Second Address | Cary, NC 27513-8158 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2012 |
Last Update Date | 17/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1184987042 | (05) | NC |
ML2786614 | DEA (01) | NC |