Healthcare Provider Details

I. General information

NPI: 1447893912
Provider Name (Legal Business Name): MARISA ZENAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 W LIBERTY RD STE F1
ANN ARBOR MI
48103-9746
US

IV. Provider business mailing address

3200 W LIBERTY RD STE F1
ANN ARBOR MI
48103-9746
US

V. Phone/Fax

Practice location:
  • Phone: 734-780-7080
  • Fax: 734-545-8663
Mailing address:
  • Phone: 734-780-7080
  • Fax: 734-545-8663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: