Provider Demographics
NPI:1952382236
Name:ZILAFRO, DILLIE M (ANPC MSN RNC)
Entity type:Individual
Prefix:
First Name:DILLIE
Middle Name:M
Last Name:ZILAFRO
Suffix:
Gender:F
Credentials:ANPC MSN RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 W MAIN ST
Mailing Address - Street 2:STE 101
Mailing Address - City:IONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48846-1652
Mailing Address - Country:US
Mailing Address - Phone:616-527-3250
Mailing Address - Fax:616-523-1899
Practice Address - Street 1:537 W MAIN ST
Practice Address - Street 2:STE 101
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-1652
Practice Address - Country:US
Practice Address - Phone:616-527-3250
Practice Address - Fax:616-523-1899
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704068471163W00000X, 363LF0000X
MIZIL104287650163WP2201X
MI07231221363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
4180767OtherMOLINA
7000045201OtherPRIORITY HEALTH
MI4180767Medicaid
0875188OtherBCBS
0875188OtherBCBS
S27117Medicare UPIN
MI4180767Medicaid
ON47460Medicare ID - Type Unspecified