Healthcare Provider Details

I. General information

NPI: 1588097455
Provider Name (Legal Business Name): MICHELLE SZYMANSKI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2013
Last Update Date: 09/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 PARK ST EMERGENCY DEPARTMENT
HONESDALE PA
18431-1445
US

IV. Provider business mailing address

38935 ANN ARBOR RD
LIVONIA MI
48150-3397
US

V. Phone/Fax

Practice location:
  • Phone: 570-253-8140
  • Fax: 570-253-8633
Mailing address:
  • Phone: 734-805-0488
  • Fax: 866-250-6385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP013048
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: