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General NPI Number Information
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NPI Number | 1780030981
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Entity Type | Individual
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Provider Name | KEVIN ZELLNER APRN
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Gender | Male
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Dates
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Enumeration Date | 05/06/2016
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 707 NE 21ST ST
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City | NEWCASTLE
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State | OK
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Zip | 73065-6179
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Country | US
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Telephone | 405-924-6992
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Fax |
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Provider Business Mailing Address
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Address Line | 733 TURTLE CREEK RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73170-1608
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Country | US
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Telephone | 405-924-6992
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 103197
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1055990
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License Number State | TX
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