Provider Demographics
NPI:1336438274
Name:ZOLLINGER, JUDY MARLENE
Entity type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:MARLENE
Last Name:ZOLLINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:MARLENE
Other - Last Name:LOCKHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1213
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAVERNE
Mailing Address - State:OK
Mailing Address - Zip Code:73848-0783
Mailing Address - Country:US
Mailing Address - Phone:580-334-0912
Mailing Address - Fax:
Practice Address - Street 1:1213 HANKS TRAIL
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-1213
Practice Address - Country:US
Practice Address - Phone:580-334-0912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator