MEDICARE: JASON ZELLER FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APN0000020263	TN

General Provider Information

NPI Number	:	1437519857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON ZELLER FNP-BC

Provider Business Mailing Address
First Line	:	501 GREAT CIRCLE RD
Second Line	:	STE 200
City	:	NASHVILLE
State	:	TN
Zip	:	37228-1330
Country	:	US
Telephone Number	:	615-284-2015
Fax Number	:	615-284-2005

Provider Business Practice Location Address
First Line	:	1911 STATE STREET
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2209
Country	:	US
Telephone Number	:	615-284-2015
Fax Number	:	615-284-2005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2016
Last Update Date	:	07/22/2016

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