Healthcare Provider Details

I. General information

NPI: 1407235757
Provider Name (Legal Business Name): MICHAEL ZEMKE JR. CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2015
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MEDICAL CENTER BLVD
MARRERO LA
70072-3147
US

IV. Provider business mailing address

3510 N CAUSEWAY BLVD STE 404
METAIRIE LA
70002-3531
US

V. Phone/Fax

Practice location:
  • Phone: 504-347-5511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number102567
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN127202
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: