Provider Demographics
NPI:1154988608
Name:ZEIGLER, JANA
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:ZEIGLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 WILKINSON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1322
Mailing Address - Country:US
Mailing Address - Phone:734-255-4578
Mailing Address - Fax:
Practice Address - Street 1:14650 E OLD US HIGHWAY 12 STE 105
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1808
Practice Address - Country:US
Practice Address - Phone:734-593-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601009441APP19363A00000X
MI5601009441363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant