MARY AMANDA AMANDA PITTMAN NPI 1609238518

NPI Information

NPI: 1609238518
Provider Name: MARY AMANDA AMANDA PITTMAN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
STUDENT SUCCESS CENTER ROOM 0222
EDWARDSVILLE, IL
ZIP 62026
Phone: (618) 650-2842
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Mary Amanda Amanda Pittman is a family nurse practitioner in Edwardsville, IL. Mary Amanda Amanda Pittman NPI is 1609238518. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

STUDENT SUCCESS CENTER ROOM 0222
EDWARDSVILLE, IL
ZIP 62026-166
Phone: (618) 650-2842
Fax: (618) 650-5839

The enumeration date for this NPI number is 3/22/2016 and was last updated on 10/23/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	277002173	ILLINOIS	No
2	363LF0000X	Nurse Practitioner	Family	277002173	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	277002173	OTHER	ILLINOIS	IDFPR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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