Healthcare Provider Details

I. General information

NPI: 1962331884
Provider Name (Legal Business Name): AMAYA VAN ZANDT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19018 E 37TH TER S
INDEPENDENCE MO
64057-2396
US

IV. Provider business mailing address

19018 E 37TH TER S APT 9
INDEPENDENCE MO
64057-2629
US

V. Phone/Fax

Practice location:
  • Phone: 903-480-9331
  • Fax:
Mailing address:
  • Phone: 903-480-9331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: