Healthcare Provider Details

I. General information

NPI: 1184352205
Provider Name (Legal Business Name): ZELLA ANN CAREY MSN, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 W 12TH ST
ERIE PA
16501-1724
US

IV. Provider business mailing address

121 W 12TH ST
ERIE PA
16501-1724
US

V. Phone/Fax

Practice location:
  • Phone: 844-456-5433
  • Fax: 814-456-0383
Mailing address:
  • Phone: 844-456-5433
  • Fax: 814-456-0383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License NumberRN753691
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP026239
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: