Provider Demographics
NPI:1912237561
Name:ZELLERS, NICOLE LEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:LEE
Last Name:ZELLERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:LEE
Other - Last Name:DELOREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1035 SHENANDOAH DR
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-0191
Mailing Address - Country:US
Mailing Address - Phone:775-443-7609
Mailing Address - Fax:
Practice Address - Street 1:1000 LOCUST ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2597
Practice Address - Country:US
Practice Address - Phone:775-328-1275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV21571541163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse