Provider Demographics
NPI:1700158037
Name:ZAWACKI, CATHERINE MARY (RN, BSN, BS)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:MARY
Last Name:ZAWACKI
Suffix:
Gender:F
Credentials:RN, BSN, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 VILLAGE GREEN BLVD
Mailing Address - Street 2:APT. # 101
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2780
Mailing Address - Country:US
Mailing Address - Phone:734-994-3072
Mailing Address - Fax:
Practice Address - Street 1:442 VILLAGE GREEN BLVD
Practice Address - Street 2:APT. # 101
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2780
Practice Address - Country:US
Practice Address - Phone:734-994-3072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704200127163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health