Provider Demographics
NPI:1962018952
Name:ZELLER, MARLENE HILDEGARD (WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MARLENE
Middle Name:HILDEGARD
Last Name:ZELLER
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16630 S 38TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-7944
Mailing Address - Country:US
Mailing Address - Phone:480-710-3308
Mailing Address - Fax:
Practice Address - Street 1:16630 S 38TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-7944
Practice Address - Country:US
Practice Address - Phone:480-710-3308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ247572363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health