Healthcare Provider Details

I. General information

NPI: 1316650021
Provider Name (Legal Business Name): NATHANIEL THOMAS ZAVETA CNA, HHA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2022
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 MERRILL ST
LANSING MI
48912-4324
US

IV. Provider business mailing address

730 MERRILL ST
LANSING MI
48912-4324
US

V. Phone/Fax

Practice location:
  • Phone: 517-179-8588
  • Fax:
Mailing address:
  • Phone: 517-179-8588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberMI00023206
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: