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Individual

AMANDA DITTMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
3191 HARBOR BLVD STE B, PORT CHARLOTTE, FL 33952-6755
(941) 883-4518
Mailing address
6360 TECHSTER BLVD STE 1, FORT MYERS, FL 33966-4805
(239) 236-8784

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
APRN9268426
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN9268426
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100028500
FL
Enumeration date
07/13/2016
Last updated
06/05/2019
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