Individual provider · Type 1 NPI
Amy Michelle Provenzano, CPNP-PC
Pediatric Nurse Practitioner · Warren, NJ
NPI number
1487178687
Active
Practice location
67A Mountain Boulevard Ext, 1st Floor, Unit B
Warren, NJ 07059
Mailing address
751 Orwell St
Lithopolis, OH 43136-9723
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | APRN.CNP.021402 (OH) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | NUR-2023-000730 (NJ) |
| Pediatric Nurse Practitioner | 363LP0200X | 95022954 (CA) |
Pediatric Nurse Practitioner: Definition to come...
Other pediatric nurse practitioner providers in Warren
About NPI 1487178687
Amy Michelle Provenzano, CPNP-PC's National Provider Identifier is 1487178687, issued on Jul 28, 2017. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Warren, NJ. The record was last updated on Feb 2, 2023.