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Individual

ZACHARY TYLER SANFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1201 11TH AVE S, BIRMINGHAM, AL 35205-3423
(205) 934-3411
Mailing address
1201 11TH AVE S, BIRMINGHAM, AL 35205-3423

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-168639
AL
363LF0000X
Family Nurse Practitioner
Primary
1-168639
AL

Other

Enumeration date
04/13/2020
Last updated
09/13/2021
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