Provider Demographics
NPI:1568355972
Name:ZELLERS, ALEXIS JADE
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:JADE
Last Name:ZELLERS
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 1:1756 CLOVE ESTATES CIR
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-9519
Mailing Address - Country:US
Mailing Address - Phone:610-984-5867
Mailing Address - Fax:610-984-5867
Practice Address - Street 1:1756 CLOVE ESTATES CIR
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-9519
Practice Address - Country:US
Practice Address - Phone:610-984-5867
Practice Address - Fax:610-984-5867
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator