Provider Demographics
NPI:1124805700
Name:ZEVIAR, SHAELLYN K (A-GNP-C)
Entity type:Individual
Prefix:MRS
First Name:SHAELLYN
Middle Name:K
Last Name:ZEVIAR
Suffix:
Gender:F
Credentials:A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6712 STAFFORD PARK DR
Mailing Address - Street 2:
Mailing Address - City:MOSELEY
Mailing Address - State:VA
Mailing Address - Zip Code:23120-2293
Mailing Address - Country:US
Mailing Address - Phone:804-896-2809
Mailing Address - Fax:
Practice Address - Street 1:8830 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:AMELIA COURT HOUSE
Practice Address - State:VA
Practice Address - Zip Code:23002-4826
Practice Address - Country:US
Practice Address - Phone:804-561-5611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024188002363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology