Individual
ZACHARY GAGE NUSSBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1492 S MILL AVE STE 206, TEMPE, AZ 85281-5664
(480) 508-0882
Mailing address
1492 S MILL AVE STE 206214, TEMPE, AZ 85281-5652
(480) 427-6645
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10525
AZ
363AM0700X
Medical Physician Assistant
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
10525
AZ
Other
Enumeration date
06/17/2024
Last updated
08/14/2025
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