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General NPI Number Information
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NPI Number | 1053796482
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Entity Type | Individual
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Provider Name | AMY R NITTA MS, FNP
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Gender | Female
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 2315 STOCKTON BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95817-2201
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Country | US
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Telephone | 916-734-2011
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 ANDERSON RD
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City | DAVIS
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State | CA
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Zip | 95616-0917
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Country | US
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Telephone | 530-665-9251
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95002783
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License Number State | CA
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