1780072538 NPI number — MRS. RONNA LEE-WARNER ZELUFF P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780072538 NPI number — MRS. RONNA LEE-WARNER ZELUFF P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZELUFF
Provider First Name:
RONNA
Provider Middle Name:
LEE-WARNER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WARNER
Provider Other First Name:
RONNA
Provider Other Middle Name:
LEE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1780072538
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/02/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
131 SUMMIT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALLEGAN
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49010-8627
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-492-5569
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
363 FREMONT ST
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
BATTLE CREEK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49017-3389
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-969-6123
Provider Business Practice Location Address Fax Number:
269-969-6122
Provider Enumeration Date:
01/02/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  5601007255 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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