Healthcare Provider Details

I. General information

NPI: 1013317809
Provider Name (Legal Business Name): AMY ZITNEY CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2014
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 SOM CENTER RD
WILLOUGHBY HILLS OH
44094-9607
US

IV. Provider business mailing address

3815 FALLS RD
CHAGRIN FALLS OH
44022-2536
US

V. Phone/Fax

Practice location:
  • Phone: 440-943-2500
  • Fax:
Mailing address:
  • Phone: 216-374-8976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN235229
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCOA05465NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: