Healthcare Provider Details

I. General information

NPI: 1407280654
Provider Name (Legal Business Name): AMANDA JEAN PITTS DNP, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2013
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E 9TH ST
CORALVILLE IA
52241-2209
US

IV. Provider business mailing address

105 E 9TH ST DEPT OF
CORALVILLE IA
52241-2209
US

V. Phone/Fax

Practice location:
  • Phone: 319-467-2000
  • Fax: 319-467-2410
Mailing address:
  • Phone: 319-467-2000
  • Fax: 319-467-2506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberH115123
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: