Healthcare Provider Details

I. General information

NPI: 1295166312
Provider Name (Legal Business Name): MICHELLE MARIE ZAHN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2013
Last Update Date: 07/08/2020
Certification Date: 07/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2175 MAIN ST
DUNEDIN FL
34698-5606
US

IV. Provider business mailing address

2175 MAIN ST
DUNEDIN FL
34698-5606
US

V. Phone/Fax

Practice location:
  • Phone: 727-733-6241
  • Fax:
Mailing address:
  • Phone: 612-300-5732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9202017
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR 144535-0
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: