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General NPI Number Information
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NPI Number | 1003563271
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Entity Type | Individual
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Provider Name | AMANDA KAY PITTMAN APRN
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Gender | Female
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Dates
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Enumeration Date | 03/07/2022
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 1500 MUSEUM RD STE 104
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City | CONWAY
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State | AR
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Zip | 72032-4761
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Country | US
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Telephone | 501-932-9010
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Fax | 501-585-9076
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Provider Business Mailing Address
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Address Line | PO BOX 497
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City | AUGUSTA
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State | AR
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Zip | 72006-0497
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Country | US
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Telephone | 870-347-2534
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Fax | 870-301-2092
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R081287
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 163WX0200X
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Taxonomy Name | Oncology Registered Nurse
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License Number | R081287
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 220618
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License Number State | AR
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