Dittmer, Amanda

Dittmer, Amanda is an individual health care provider with primary practice located at 3191 Harbor Blvd Ste B , Port Charlotte FL 33952-6755. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Dittmer, Amanda can be contacted via phone (941) 883-4518.

Contact Information

Primary practice address
3191 Harbor Blvd Ste B Port Charlotte FL 33952-6755
Phone: (941) 883-4518
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN9268426 Florida
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X APRN9268426 Florida

Profile Details

NPI number 1134572274
LBN Legal business name Dittmer, Amanda
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2016
Last updated Jun 5th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134572274 NPPES
Florida MEDICAID 100028500

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