Provider Demographics
NPI:1689612269
Name:ZITZMANN, LORI JEAN (ANP)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:JEAN
Last Name:ZITZMANN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1544 W 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-4930
Mailing Address - Country:US
Mailing Address - Phone:907-770-6700
Mailing Address - Fax:907-770-6707
Practice Address - Street 1:915 W NORTHERN LIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2408
Practice Address - Country:US
Practice Address - Phone:907-770-6700
Practice Address - Fax:907-770-6707
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK646363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK646OtherANP LICENSE NUMBER