Pittman, Mary Amanda Amanda

Pittman, Mary Amanda Amanda is an individual health care provider with primary practice located at Student Success Center Room 0222 , Edwardsville IL 62026-1166. 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 / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Pittman, Mary Amanda Amanda can be contacted via phone (618) 650-2842.

Contact Information

Primary practice address
Student Success Center Room 0222 Edwardsville IL 62026-1166
Phone: (618) 650-2842
Fax: (618) 650-5839
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 277002173 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 277002173 Illinois

Profile Details

NPI number 1609238518
LBN Legal business name Pittman, Mary Amanda Amanda
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2016
Last updated Oct 23rd, 2023 - about 2 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 1609238518 NPPES
Illinois Other 277002173 IDFPR

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