Provider Demographics
NPI:1164953048
Name:ZELTMAN, MICAYLA JO LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:MICAYLA
Middle Name:JO LYNN
Last Name:ZELTMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MICAYLA
Other - Middle Name:JO LYNN
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1153 E MAIN ST
Mailing Address - Street 2:PO BOX 2563
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4056
Mailing Address - Country:US
Mailing Address - Phone:740-687-8990
Mailing Address - Fax:740-687-8230
Practice Address - Street 1:401 N EWING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3372
Practice Address - Country:US
Practice Address - Phone:740-689-4935
Practice Address - Fax:740-689-4889
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant