Provider Demographics
NPI:1932926573
Name:ZEKO, JEANNE MIRABELLE KELLY
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:MIRABELLE KELLY
Last Name:ZEKO
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 1:8805 PRISCILLA CT
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3540
Mailing Address - Country:US
Mailing Address - Phone:240-217-9440
Mailing Address - Fax:
Practice Address - Street 1:8805 PRISCILLA CT
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3540
Practice Address - Country:US
Practice Address - Phone:240-217-9440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator