Individual
ZACHARY THOMAS JOHNATHAN WILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
(864) 157-5522
Mailing address
3940 PENNSYLVANIA PL, LAS CRUCES, NM 88012-0814
(530) 415-4707
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
NM-86070
NM
363LF0000X
Family Nurse Practitioner
Primary
69330
NM
Other
Enumeration date
03/22/2022
Last updated
08/11/2022
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