Provider Demographics
NPI:1588055909
Name:ZIGAH, MICHELLE MARIE OPAL (LPN)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:MARIE OPAL
Last Name:ZIGAH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:MARIE OPAL
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:14 WYNDLEA CIR
Mailing Address - Street 2:
Mailing Address - City:EAST FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02536-5714
Mailing Address - Country:US
Mailing Address - Phone:218-213-1538
Mailing Address - Fax:
Practice Address - Street 1:14 WYNDLEA CIR
Practice Address - Street 2:
Practice Address - City:EAST FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02536-5714
Practice Address - Country:US
Practice Address - Phone:218-213-1538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN91753164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse