Provider Demographics
NPI:1578990891
Name:ZANE, MICHAEL PATRICK (RN)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PATRICK
Last Name:ZANE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 BURNETT AVE
Mailing Address - Street 2:APARTMENT #10
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-1575
Mailing Address - Country:US
Mailing Address - Phone:404-408-3186
Mailing Address - Fax:
Practice Address - Street 1:975 BURNETT AVE
Practice Address - Street 2:APARTMENT #10
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-1575
Practice Address - Country:US
Practice Address - Phone:404-408-3186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA793155163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse