Provider Demographics
NPI:1629316740
Name:SYPNIEWSKI, MICHELE PLANT (ARNP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:PLANT
Last Name:SYPNIEWSKI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ROSALYN
Other - Middle Name:MICHELE
Other - Last Name:PLANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8561 COMMERCE CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-3084
Mailing Address - Country:US
Mailing Address - Phone:772-807-3868
Mailing Address - Fax:
Practice Address - Street 1:8561 COMMERCE CENTRE DR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-3084
Practice Address - Country:US
Practice Address - Phone:772-807-3868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9409616363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS269410YJ5DMedicare PIN