Individual
AMANDA KAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3210 EAGLE RUN DR NE, GRAND RAPIDS, MI 49525-7051
(616) 456-9553
(616) 454-5371
Mailing address
PO BOX 150036, GRAND RAPIDS, MI 49515-0036
(616) 456-9553
(616) 454-5371
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4704252802
MI
363LA2200X
Adult Health Nurse Practitioner
4704252802
MI
Other
Enumeration date
01/21/2022
Last updated
05/24/2024
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