Healthcare Provider Details

I. General information

NPI: 1609233733
Provider Name (Legal Business Name): AMANDA COMFORT MSN, FPMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA TITTOR

II. Dates (important events)

Enumeration Date: 01/20/2016
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S PARK AVE
SPRINGFIELD MO
65802-4855
US

IV. Provider business mailing address

1300 E BRADFORD PKWY
SPRINGFIELD MO
65804-4264
US

V. Phone/Fax

Practice location:
  • Phone: 417-893-7735
  • Fax:
Mailing address:
  • Phone: 417-761-5000
  • Fax: 417-761-5111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberA004622
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2018006685
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: