Provider Demographics
NPI:1639290901
Name:ZELL, STACEY A (CRTT, RCP)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:A
Last Name:ZELL
Suffix:
Gender:F
Credentials:CRTT, RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 PARMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057-3417
Mailing Address - Country:US
Mailing Address - Phone:507-646-1000
Mailing Address - Fax:507-646-1317
Practice Address - Street 1:2000 NORTH AVENUE
Practice Address - Street 2:NORTHFIELD HOSPITAL
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057
Practice Address - Country:US
Practice Address - Phone:507-646-1000
Practice Address - Fax:507-646-1317
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1763227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified