AMY MICHELLE PROVENZANO CPNP-PC NPI 1487178687

NPI Information

NPI: 1487178687
Provider Name: AMY MICHELLE PROVENZANO, CPNP-PC
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
67A MOUNTAIN BOULEVARD EXT
1ST FLOOR, UNIT B
WARREN, NJ
ZIP 07059
Phone: (858) 216-8837
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Amy Michelle Provenzano, CPNP-PC is a pediatrics nurse practitioner in Warren, NJ. Amy Michelle Provenzano, CPNP-PC NPI is 1487178687. 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:

67A MOUNTAIN BOULEVARD EXT
1ST FLOOR, UNIT B
WARREN, NJ
ZIP 07059
Phone: (858) 216-8837

The enumeration date for this NPI number is 7/28/2017 and was last updated on 2/2/2023.

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	363LP0200X	Nurse Practitioner	Pediatrics	APRN.CNP.021402	OHIO	No
2	363LP0200X	Nurse Practitioner	Pediatrics	NUR-2023-000730	NEW JERSEY	Yes
3	363LP0200X	Nurse Practitioner	Pediatrics	95022954	CALIFORNIA	No

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: 4/28/2024

NPI Synchronization or Removal

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