Provider Demographics
NPI:1497521637
Name:ZITNICK, MICHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:ZITNICK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:BIRTWISTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:725 ORCHID DR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1840
Mailing Address - Country:US
Mailing Address - Phone:954-410-4360
Mailing Address - Fax:
Practice Address - Street 1:725 ORCHID DR
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1840
Practice Address - Country:US
Practice Address - Phone:954-410-4360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11029910363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health