Healthcare Provider Details
I. General information
NPI: 1841560950
Provider Name (Legal Business Name): AMY L. ZIRK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/05/2012
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 HIGHLAND AVE
MADISON WI
53792-0001
US
IV. Provider business mailing address
7974 UW HEALTH CT
MIDDLETON WI
53562-5531
US
V. Phone/Fax
- Phone: 608-263-6420
- Fax: 608-263-0440
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 136145 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: