Healthcare Provider Details

I. General information

NPI: 1417197880
Provider Name (Legal Business Name): AMANDA BROOKE ZEMMER MSN, RN, ACNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2009
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E APPLE ST STE 5254A
DAYTON OH
45409-2939
US

IV. Provider business mailing address

1 WYOMING ST
DAYTON OH
45409-2722
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-4200
  • Fax:
Mailing address:
  • Phone: 937-208-3772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberAPRN.CNS.14459
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number304156
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: