Healthcare Provider Details

I. General information

NPI: 1023818556
Provider Name (Legal Business Name): AMANDA SEVITS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2025
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N KEENE ST STE 201
COLUMBIA MO
65201-8131
US

IV. Provider business mailing address

105 N KEENE ST STE 201
COLUMBIA MO
65201-8131
US

V. Phone/Fax

Practice location:
  • Phone: 573-499-4990
  • Fax: 573-442-2120
Mailing address:
  • Phone: 573-499-4990
  • Fax: 573-442-2120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2024022027
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: