Provider Demographics
NPI:1346421815
Name:ZITTLE, KRISTINA GRACE (CPM, LM)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:GRACE
Last Name:ZITTLE
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5604 MCLEAN CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-8796
Mailing Address - Country:US
Mailing Address - Phone:757-479-1737
Mailing Address - Fax:
Practice Address - Street 1:5604 MCLEAN CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-8796
Practice Address - Country:US
Practice Address - Phone:757-479-1737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0129000032176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife