Provider Demographics
NPI:1295166312
Name:ZAHN, MICHELLE MARIE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:MARIE
Last Name:ZAHN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-5606
Mailing Address - Country:US
Mailing Address - Phone:612-300-5732
Mailing Address - Fax:
Practice Address - Street 1:2175 MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-5606
Practice Address - Country:US
Practice Address - Phone:727-733-6241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-29
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9202017363LF0000X
MNR 144535-0363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily