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General NPI Number Information
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NPI Number | 1346340924
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY ZEILER CRNA
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Gender | Male
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 08/29/2012
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Provider Practice Location Address
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Address Line | 3333 EVERGREEN DR NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-9493
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Country | US
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Telephone | 616-284-3134
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Fax |
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Provider Business Mailing Address
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Address Line | 16870 CRICKET CT
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City | GRAND HAVEN
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State | MI
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Zip | 49417-9693
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Country | US
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Telephone | 616-502-4608
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704216502
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4704216502
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License Number State | MI
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