Healthcare Provider Details

I. General information

NPI: 1124460589
Provider Name (Legal Business Name): MICHELLE MARIE ZANANIRI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 01/01/2026
Certification Date: 01/01/2026
Deactivation Date: 12/09/2025
Reactivation Date: 12/31/2025

III. Provider practice location address

310 AVON ST STE 9
CHARLOTTESVILLE VA
22902-5750
US

IV. Provider business mailing address

310 AVON ST STE 9
CHARLOTTESVILLE VA
22902-5750
US

V. Phone/Fax

Practice location:
  • Phone: 434-817-1818
  • Fax: 434-817-9606
Mailing address:
  • Phone: 434-817-1818
  • Fax: 434-817-9606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110008638
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA4766
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: