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NPI Code Detail

MEDICARE: JONATHAN ZYWICKI NP

MEDICARE: JONATHAN ZYWICKI NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner4704282600MI

General Provider Information

NPI Number : 1376023036
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN ZYWICKI NP
Provider Business Mailing Address
First Line : 701 US HIGHWAY 31 S
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49685-8016
Country : US
Telephone Number : 231-932-9570
Fax Number :
Provider Business Practice Location Address
First Line : 701 US HIGHWAY 31 S
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49685-8016
Country : US
Telephone Number : 231-932-9570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2018
Last Update Date : 02/02/2022

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