Provider Demographics
NPI:1770042228
Name:ZELLNER, ANDRREA MICHELLE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ANDRREA
Middle Name:MICHELLE
Last Name:ZELLNER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MISS
Other - First Name:ANDRREA
Other - Middle Name:MICHELLE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:781 SPRING ST STE 230
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-2185
Mailing Address - Country:US
Mailing Address - Phone:478-633-1547
Mailing Address - Fax:478-633-7929
Practice Address - Street 1:781 SPRING ST STE 230
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2185
Practice Address - Country:US
Practice Address - Phone:478-633-1547
Practice Address - Fax:478-633-7929
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN130270363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner