Provider Demographics
NPI:1790251114
Name:HITCHLER, AMY ANN (CNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ANN
Last Name:HITCHLER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4302 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-6625
Mailing Address - Country:US
Mailing Address - Phone:513-433-1032
Mailing Address - Fax:
Practice Address - Street 1:4302 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-6625
Practice Address - Country:US
Practice Address - Phone:513-433-1032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2018072145363LF0000X
OHAPRN.CNP.023960363LF0000X, 2084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1790251114OtherNPI
OH0383201Medicaid