Provider Demographics
NPI:1518061977
Name:KITZMILLER, AMY ELIZABETH (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ELIZABETH
Last Name:KITZMILLER
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2000 MON HEALTH MEDICAL PARK DR STE 2100
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1168
Mailing Address - Country:US
Mailing Address - Phone:304-599-6811
Mailing Address - Fax:304-599-7159
Practice Address - Street 1:2000 MON HEALTH MEDICAL PARK DR STE 2100
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1168
Practice Address - Country:US
Practice Address - Phone:304-599-6811
Practice Address - Fax:304-599-7159
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP004562V363LW0102X
WVAPRN46057363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health