Healthcare Provider Details

I. General information

NPI: 1407311897
Provider Name (Legal Business Name): MICHELLE R A ZAPATA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2019
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 HERNDON AVE
CLOVIS CA
93611-6304
US

IV. Provider business mailing address

2751 E ECLIPSE AVE
FRESNO CA
93720-5443
US

V. Phone/Fax

Practice location:
  • Phone: 559-483-9911
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95033356
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95011122
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: