Individual
MS. HOLLY NICOLE ZELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
395 INTERSTATE DR, MANCHESTER, TN 37355-3108
(872) 231-3162
Mailing address
PO BOX 74008272, CHICAGO, IL 60674-8272
(702) 899-0595
(702) 977-1496
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.002645
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067603
—
OH
01
—
12161909
CAQH
—
Enumeration date
08/10/2007
Last updated
10/06/2025
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