Healthcare Provider Details

I. General information

NPI: 1740342112
Provider Name (Legal Business Name): SHAWN MARIE ZELLMER RN, MSN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 NC HIGHWAY 45 N
PLYMOUTH NC
27962-9232
US

IV. Provider business mailing address

198 NC HIGHWAY 45 N
PLYMOUTH NC
27962-9232
US

V. Phone/Fax

Practice location:
  • Phone: 252-791-3111
  • Fax:
Mailing address:
  • Phone: 252-791-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number114434
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number300318
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: