Healthcare Provider Details

I. General information

NPI: 1669388252
Provider Name (Legal Business Name): AMANDA LYNN DEITS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ROCKY MOUNTAIN AVE
LOVELAND CO
80538-9004
US

IV. Provider business mailing address

4514 BEAUFORTS DR
WINDSOR CO
80550-6086
US

V. Phone/Fax

Practice location:
  • Phone: 970-336-1500
  • Fax:
Mailing address:
  • Phone: 719-229-1298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1002267
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: