Provider Demographics
NPI:1033176284
Name:WITTE, AMY (FNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:WITTE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2643 PATTERSON RD STE 603
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-1937
Mailing Address - Country:US
Mailing Address - Phone:970-298-3801
Mailing Address - Fax:970-232-2860
Practice Address - Street 1:2643 PATTERSON RD STE 603
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1937
Practice Address - Country:US
Practice Address - Phone:970-298-3801
Practice Address - Fax:970-232-2860
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO117046363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO79250025Medicaid
COCO303215Medicare PIN