Provider Demographics
NPI:1780932137
Name:DONZELL, CHRISTOPHER MICHAEL (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:DONZELL
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1866 S MOREY RD
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49651-9190
Mailing Address - Country:US
Mailing Address - Phone:231-839-7282
Mailing Address - Fax:231-839-7222
Practice Address - Street 1:1866 S MOREY RD
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:MI
Practice Address - Zip Code:49651-9190
Practice Address - Country:US
Practice Address - Phone:231-839-7282
Practice Address - Fax:231-839-7222
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704239421363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily