Provider Demographics
NPI:1386183804
Name:ZELLNER, ELIZABETH TAYLOR (ARNP AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:TAYLOR
Last Name:ZELLNER
Suffix:
Gender:F
Credentials:ARNP AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:904-296-5691
Mailing Address - Fax:904-450-6401
Practice Address - Street 1:4203 BELFORT RD STE 345
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1469
Practice Address - Country:US
Practice Address - Phone:904-450-6461
Practice Address - Fax:904-450-6469
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP3056472363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology