AMANDA DITTMER APRN NPI 1134572274

NPI Information

NPI: 1134572274
Provider Name: AMANDA DITTMER, APRN
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
3191 HARBOR BLVD STE B
PORT CHARLOTTE, FL
ZIP 33952
Phone: (941) 883-4518
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Amanda Dittmer, APRN is a psychiatric/mental health nurse practitioner in Port Charlotte, FL. Amanda Dittmer, APRN NPI is 1134572274. 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:

3191 HARBOR BLVD STE B
PORT CHARLOTTE, FL
ZIP 33952-755
Phone: (941) 883-4518

The NPI 1134572274 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/13/2016 and was last updated on 6/5/2019.

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	APRN9268426	FLORIDA	Yes
2	363LP0200X	Nurse Practitioner	Pediatrics	APRN9268426	FLORIDA	No

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	100028500	MEDICAID	FLORIDA

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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