Basic Information
| Provider Information | |||||||||
| NPI: | 1215485362 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZERPA | ||||||||
| FirstName: | MICHELLE | ||||||||
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| Credential: | N.P | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18659 TAMIAMI TRAIL | ||||||||
| Address2: | SUITE A | ||||||||
| City: | NORTH PORT | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342877388 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9414293416 | ||||||||
| FaxNumber: | 9414293430 | ||||||||
| Practice Location | |||||||||
| Address1: | 8270 COLLEGE PKWY STE 130 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339195107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393223434 | ||||||||
| FaxNumber: | 7205980440 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2016 | ||||||||
| LastUpdateDate: | 08/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 21693 | TN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | APRN9217943 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.