Provider Demographics
NPI:1255087490
Name:PITTS, AMBER A (RN)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:A
Last Name:PITTS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12339 HANDLES PEAK WAY
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-4462
Mailing Address - Country:US
Mailing Address - Phone:719-500-8482
Mailing Address - Fax:
Practice Address - Street 1:12339 HANDLES PEAK WAY
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-4462
Practice Address - Country:US
Practice Address - Phone:719-500-8482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1668708163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management