Healthcare Provider Details

I. General information

NPI: 1104488212
Provider Name (Legal Business Name): ASHLEY NICOLE ZEILENGA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 NE SAINT LUKES BLVD STE 310
LEES SUMMIT MO
64086-6001
US

IV. Provider business mailing address

29751 LITTLE MACK AVE STE B
ROSEVILLE MI
48066-6504
US

V. Phone/Fax

Practice location:
  • Phone: 816-282-7809
  • Fax:
Mailing address:
  • Phone: 586-415-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5101027391
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5151014112
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: