Provider Demographics
NPI:1922718949
Name:SUTTON, AMANDA (APRN CNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:SUTTON
Suffix:
Gender:F
Credentials:APRN CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2607
Mailing Address - Country:US
Mailing Address - Phone:513-853-9700
Mailing Address - Fax:513-852-8967
Practice Address - Street 1:4605 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2607
Practice Address - Country:US
Practice Address - Phone:513-853-9700
Practice Address - Fax:513-852-8967
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0032721363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily