Provider Demographics
NPI:1437519857
Name:ZELLER, JASON (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:ZELLER
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GREAT CIRCLE RD
Mailing Address - Street 2:STE 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1330
Mailing Address - Country:US
Mailing Address - Phone:615-284-2015
Mailing Address - Fax:615-284-2005
Practice Address - Street 1:1911 STATE STREET
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2209
Practice Address - Country:US
Practice Address - Phone:615-284-2015
Practice Address - Fax:615-284-2005
Is Sole Proprietor?:No
Enumeration Date:2016-02-26
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000020263363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I505661Medicare PIN