MEDICARE: MICHELLE PETERS ZAPPAS DNP, FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	NP95002345	CA
2	363LF0000X	Family Nurse Practitioner	F335854-1	NY

General Provider Information

NPI Number	:	1518194091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE PETERS ZAPPAS DNP, FNP

Provider Business Mailing Address
First Line	:	5205 MELROSE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90038-3144
Country	:	US
Telephone Number	:	323-653-1990
Fax Number	:

Provider Business Practice Location Address
First Line	:	324 E 149TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-5602
Country	:	US
Telephone Number	:	718-665-4300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2009
Last Update Date	:	11/19/2015

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