Provider Demographics
NPI:1841095411
Name:VITELLI, AMANDA (RN)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:
Last Name:VITELLI
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 1:206 DEANN DR APT 7
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97351-2533
Mailing Address - Country:US
Mailing Address - Phone:941-730-2953
Mailing Address - Fax:
Practice Address - Street 1:206 DEANN DR APT 7
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OR
Practice Address - Zip Code:97351-2533
Practice Address - Country:US
Practice Address - Phone:941-730-2953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10021612163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health