Healthcare Provider Details
I. General information
NPI: 1891507745
Provider Name (Legal Business Name): ANNE E ZOLLMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/27/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
550 S LANDMARK AVE
BLOOMINGTON IN
47403-3239
US
IV. Provider business mailing address
715 CRYSTAL COURT DR
BEDFORD IN
47421-6777
US
V. Phone/Fax
- Phone: 812-333-5973
- Fax:
- Phone: 330-604-5576
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 28273989A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 71016420A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: