Individual
MS. VICKIE MARIE ZELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1001 DIVISION ST, PRESCOTT, AZ 86301-1618
(928) 445-4818
(928) 445-4837
Mailing address
11301 N T QUARTER CIR, PRESCOTT VALLEY, AZ 86315
(928) 848-8865
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3783
STATE LICENSE
AZ
05
—
788372
—
AZ
01
—
Z183308
MEDICARE PTAN
AZ
Enumeration date
04/04/2006
Last updated
02/28/2017
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