Provider Demographics
NPI:1154310159
Name:MOYER, ZELL Y (CRNA)
Entity Type:Individual
Prefix:MR
First Name:ZELL
Middle Name:Y
Last Name:MOYER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2553 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17857-8704
Mailing Address - Country:US
Mailing Address - Phone:570-473-3633
Mailing Address - Fax:
Practice Address - Street 1:66 ENTERPRISE BLVD
Practice Address - Street 2:
Practice Address - City:ALLENWOOD
Practice Address - State:PA
Practice Address - Zip Code:17810
Practice Address - Country:US
Practice Address - Phone:570-966-3000
Practice Address - Fax:570-538-1975
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN2611492367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered