Provider Demographics
NPI:1528620473
Name:ZELLERS, LILLIA AFTON (APRN-C)
Entity type:Individual
Prefix:MRS
First Name:LILLIA
Middle Name:AFTON
Last Name:ZELLERS
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:TAZEWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37879-4323
Mailing Address - Country:US
Mailing Address - Phone:865-658-5454
Mailing Address - Fax:423-259-8662
Practice Address - Street 1:951 N BROAD ST
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:TN
Practice Address - Zip Code:37879-4323
Practice Address - Country:US
Practice Address - Phone:865-658-5454
Practice Address - Fax:423-259-8662
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25917207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
APN0000029517OtherAPN0000025917
TN25917OtherLISENCE NUMBER