Healthcare Provider Details

I. General information

NPI: 1184484909
Provider Name (Legal Business Name): PAIGE ZAJDA NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 03/20/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6210 W MAIN ST
KALAMAZOO MI
49009-8925
US

IV. Provider business mailing address

1423 ELLINGTON DR
KALAMAZOO MI
49009-3711
US

V. Phone/Fax

Practice location:
  • Phone: 269-286-7030
  • Fax: 269-286-7031
Mailing address:
  • Phone: 269-615-0061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number470334495
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: