Healthcare Provider Details

I. General information

NPI: 1538082854
Provider Name (Legal Business Name): JACQUELYNN ZELLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 OAK HARBOR BLVD
SLIDELL LA
70458-8825
US

IV. Provider business mailing address

16112 E 196TH ST
NOBLESVILLE IN
46060-9234
US

V. Phone/Fax

Practice location:
  • Phone: 985-707-2790
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28179393C
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: