Provider Demographics
NPI:1750030136
Name:ZITTERKOPF, JENNIFER (CPC, LIMHP)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:ZITTERKOPF
Suffix:
Gender:F
Credentials:CPC, LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 W 56TH ST APT 206
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-1032
Mailing Address - Country:US
Mailing Address - Phone:423-596-4978
Mailing Address - Fax:
Practice Address - Street 1:820 W 56TH ST APT 206
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-1032
Practice Address - Country:US
Practice Address - Phone:423-596-4978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2915101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2915OtherPRIVATE AND GROUP INSURANCE
NE2915Medicaid