Healthcare Provider Details

I. General information

NPI: 1821605403
Provider Name (Legal Business Name): ALLEN ZELNO CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2020
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E MOUNTAIN DR
WILKES BARRE PA
18711-0027
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-808-6020
  • Fax: 570-808-2306
Mailing address:
  • Phone: 570-808-6020
  • Fax: 570-808-2306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP022306
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: