Provider Demographics
NPI:1437462116
Name:PLAISTED, MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:PLAISTED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHELLI
Other - Middle Name:
Other - Last Name:ZINK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3685 TAVERN WAY
Mailing Address - Street 2:
Mailing Address - City:TRIANGLE
Mailing Address - State:VA
Mailing Address - Zip Code:22172-1034
Mailing Address - Country:US
Mailing Address - Phone:703-662-3891
Mailing Address - Fax:
Practice Address - Street 1:3685 TAVERN WAY
Practice Address - Street 2:
Practice Address - City:TRIANGLE
Practice Address - State:VA
Practice Address - Zip Code:22172-1034
Practice Address - Country:US
Practice Address - Phone:703-662-3891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula