Healthcare Provider Details

I. General information

NPI: 1699240903
Provider Name (Legal Business Name): AMANDA KAYE PITTSLEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9218 KIMMER DR STE 207
LONE TREE CO
80124-6733
US

IV. Provider business mailing address

1805 SHEA CENTER DR STE 450
HIGHLANDS RANCH CO
80129-2255
US

V. Phone/Fax

Practice location:
  • Phone: 720-493-9006
  • Fax: 720-242-7520
Mailing address:
  • Phone: 303-357-2559
  • Fax: 720-242-7520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberC-APN.0105223-C-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95019480
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: