Provider Demographics
NPI:1285100115
Name:PREZENKOWSKI, MICHELE LYN (CNP)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:LYN
Last Name:PREZENKOWSKI
Suffix:
Gender:
Credentials:CNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7225 OLD OAK BLVD.
Mailing Address - Street 2:A210
Mailing Address - City:MIDDLEBURG HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130
Mailing Address - Country:US
Mailing Address - Phone:440-816-2761
Mailing Address - Fax:440-816-8065
Practice Address - Street 1:14401 SNOW RD
Practice Address - Street 2:
Practice Address - City:BROOKPARK
Practice Address - State:OH
Practice Address - Zip Code:44142-2583
Practice Address - Country:US
Practice Address - Phone:216-898-2229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023767207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine