Healthcare Provider Details

I. General information

NPI: 1942557731
Provider Name (Legal Business Name): MICHELLE LEE ZANCONATO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2012
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 WALL ST
BURLINGTON MA
01803-4758
US

IV. Provider business mailing address

20 WALL ST
BURLINGTON MA
01803-4758
US

V. Phone/Fax

Practice location:
  • Phone: 781-221-2600
  • Fax:
Mailing address:
  • Phone: 781-221-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2324017
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: