Provider Demographics
NPI:1710691522
Name:MUITER, AMANDA RAE (NP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:RAE
Last Name:MUITER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 M ST NE APT 420
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-6796
Mailing Address - Country:US
Mailing Address - Phone:917-657-4151
Mailing Address - Fax:
Practice Address - Street 1:2440 M ST NW STE 801
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1474
Practice Address - Country:US
Practice Address - Phone:202-742-3999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP1042329363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily