Provider Demographics
NPI:1871707190
Name:ZELLNER, SHELLY ANN (CTRS)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:ANN
Last Name:ZELLNER
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 WATERSIDE CV
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-5833
Mailing Address - Country:US
Mailing Address - Phone:501-425-3681
Mailing Address - Fax:
Practice Address - Street 1:20400 COLONEL GLENN RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72210-5323
Practice Address - Country:US
Practice Address - Phone:501-821-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist