Provider Demographics
NPI:1497261234
Name:TOLER, ZELMA RAE (PCA)
Entity Type:Individual
Prefix:MS
First Name:ZELMA
Middle Name:RAE
Last Name:TOLER
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:MS
Other - First Name:ZELMA
Other - Middle Name:RAE
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 623
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:WV
Mailing Address - Zip Code:25570
Mailing Address - Country:US
Mailing Address - Phone:304-356-4562
Mailing Address - Fax:304-558-4563
Practice Address - Street 1:112 RIVERSIDE DRIVE
Practice Address - Street 2:DUNROVAN ESTATE
Practice Address - City:WAYNE
Practice Address - State:WV
Practice Address - Zip Code:25570
Practice Address - Country:US
Practice Address - Phone:304-523-5484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
0034210000OtherPROVIDER ID