Amde-Michael, Tizita
Amde-Michael, Tizita is an individual health care provider with primary practice located at 600 St Paul Ave Suite 200, Los Angeles CA 90017-2038. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Amde-Michael, Tizita can be contacted via phone (213) 482-6400.Contact Information
Primary practice address
600 St Paul Ave Suite 200
Los Angeles CA 90017-2038
Phone: (213) 482-6400
Fax: (213) 482-6408
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 17768 | California |
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 661686 | California |
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 4436 | Wisconsin |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 17768 | California |
Profile Details
| NPI number | 1578731147 |
|---|---|
| LBN Legal business name | Amde-Michael, Tizita |
| Credentials | Certified Pediatric Nurse Practitioner (CPNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2008 |
| Last updated | Jan 8th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578731147 | NPPES |
| Wisconsin | MEDICAID | 1578731147 | |
| Wisconsin | MEDICAID | 100500484 | |
| Wisconsin | MEDICAID | 100500484 GROUP |
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