MEDICARE: MALLORI ZECHIEL FNP-C

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	363LP2300X	Primary Care Nurse Practitioner	71017866A	IN

General Provider Information

NPI Number	:	1740137033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALLORI ZECHIEL FNP-C

Provider Business Mailing Address
First Line	:	11750 20B RD
Second Line	:
City	:	ARGOS
State	:	IN
Zip	:	46501-9761
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	902 PROVIDENT DR STE C
Second Line	:
City	:	WARSAW
State	:	IN
Zip	:	46580-3379
Country	:	US
Telephone Number	:	574-269-8338
Fax Number	:

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

Provider Enumeration Date	:	03/14/2026
Last Update Date	:	03/14/2026

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