Provider Demographics
NPI:1316650021
Name:ZAVETA, NATHANIEL THOMAS (CNA, HHA)
Entity type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:THOMAS
Last Name:ZAVETA
Suffix:
Gender:
Credentials:CNA, HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 MERRILL ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-4324
Mailing Address - Country:US
Mailing Address - Phone:517-179-8588
Mailing Address - Fax:
Practice Address - Street 1:730 MERRILL ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-4324
Practice Address - Country:US
Practice Address - Phone:517-179-8588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI000232063747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant