Provider Demographics
NPI:1922619642
Name:PLATZER, MICHELLE MARIE
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:MARIE
Last Name:PLATZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 ARAMINGO AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-4607
Mailing Address - Country:US
Mailing Address - Phone:215-444-7274
Mailing Address - Fax:215-979-6726
Practice Address - Street 1:3621 ARAMINGO AVE # C5
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-4607
Practice Address - Country:US
Practice Address - Phone:215-444-7472
Practice Address - Fax:215-979-6726
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020787363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner