Provider Demographics
NPI:1316104391
Name:ZELLER, ALICE M (RN)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:M
Last Name:ZELLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2263 MAIN DR
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177-9738
Mailing Address - Country:US
Mailing Address - Phone:304-721-6898
Mailing Address - Fax:
Practice Address - Street 1:2263 MAIN DR
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:WV
Practice Address - Zip Code:25177-9738
Practice Address - Country:US
Practice Address - Phone:304-721-6898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV60400163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine