Provider Demographics
NPI:1003172917
Name:PIETRAGALLO, AMY ELIZABETH (RN, MSN, ACNP-BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:PIETRAGALLO
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Gender:F
Credentials:RN, MSN, ACNP-BC
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Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-6159
Mailing Address - Fax:614-257-3140
Practice Address - Street 1:181 TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1779
Practice Address - Country:US
Practice Address - Phone:614-293-7677
Practice Address - Fax:614-293-2867
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2021-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.13271363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0151700Medicaid
OHH317030Medicare PIN