Provider Demographics
NPI:1407280654
Name:PITTS, AMANDA JEAN (DNP, ARNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:JEAN
Last Name:PITTS
Suffix:
Gender:
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E 9TH ST DEPT OF
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2209
Mailing Address - Country:US
Mailing Address - Phone:319-467-2000
Mailing Address - Fax:319-467-2506
Practice Address - Street 1:105 E 9TH ST
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2209
Practice Address - Country:US
Practice Address - Phone:319-467-2000
Practice Address - Fax:319-467-2410
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH115123363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health