Provider Demographics
NPI:1336577709
Name:STRUBLE, ZELLENE (CPM, LMT)
Entity Type:Individual
Prefix:
First Name:ZELLENE
Middle Name:
Last Name:STRUBLE
Suffix:
Gender:F
Credentials:CPM, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 101
Mailing Address - Street 2:
Mailing Address - City:HARPERS FERRY
Mailing Address - State:WV
Mailing Address - Zip Code:25425-0101
Mailing Address - Country:US
Mailing Address - Phone:240-285-4223
Mailing Address - Fax:
Practice Address - Street 1:405 SWEETBRIAR RD
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25405
Practice Address - Country:US
Practice Address - Phone:240-285-4223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-23
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0129000089176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife