Healthcare Provider Details

I. General information

NPI: 1801606884
Provider Name (Legal Business Name): AMANDA JO ZITTEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 OAKLAND DR
KALAMAZOO MI
49008-1282
US

IV. Provider business mailing address

1000 OAKLAND DR
KALAMAZOO MI
49008-1282
US

V. Phone/Fax

Practice location:
  • Phone: 269-337-6300
  • Fax: 269-337-6434
Mailing address:
  • Phone: 269-337-6300
  • Fax: 269-337-6434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number704312323
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: