Individual provider · Type 1 NPI

Mary Amanda Amanda Pittman

Family Nurse Practitioner · Edwardsville, IL

NPI number 1609238518 Active

Practice location

Student Success Center Room 0222
Edwardsville, IL 62026-1166

Call (618) 650-2842 Map

Fax (618) 650-5839

Mailing address

7503 S Ridge Ct
Maryville, IL 62062-6442

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner 363LP0808X277002173 (IL)
Family Nurse Practitioner Primary 363LF0000X277002173 (IL)

Family Nurse Practitioner: Definition to come...

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About NPI 1609238518

Mary Amanda Amanda Pittman's National Provider Identifier is 1609238518, issued on Mar 22, 2016. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Edwardsville, IL. The record was last updated on Oct 23, 2023.