Amy M Provenzano, CPNP-PC
Nurse Practitioner, Pediatrics in Warren, New Jersey
1487178687- Practice location
- 67A Mountain Boulevard Ext, 1ST Floor, Unit B, Warren, NJ 07059
- Phone
- 858-216-8837
- Fax
- —
- Last updated
- February 2, 2023
Amy Michelle Provenzano is a Nurse Practitioner, Pediatrics based in Warren, NJ. Amy Michelle Provenzano practices in Warren, NJ and has the professional credentials of CPNP-PC. The NPI Number for Amy Michelle Provenzano is 1487178687 and holds a License No. APRN.CNP.021402 (OH). The current practice location address for Amy Michelle Provenzano is 67A Mountain Boulevard Ext, 1ST Floor, Unit B, Warren, NJ 07059 and can be reached out via phone at 858-216-8837.
Provider Profile Details
- NPI Number
- 1487178687
- Provider Name
- Amy Michelle Provenzano
- Credential
- CPNP-PC
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 67A Mountain Boulevard Ext, 1ST Floor, Unit B, Warren, NJ 07059
- Phone Number
- 858-216-8837
- Primary Taxonomy
- Nurse Practitioner, Pediatrics · 363LP0200X
- Sole Proprietor
- No
- Provider Enumeration Date
- July 28, 2017
- Last Update Date
- February 2, 2023
- Certification Date
- February 1, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 67A Mountain Boulevard Ext
1ST Floor, Unit B
Warren, NJ 07059 - City
- Warren
- State
- New Jersey
- Zip
- 07059
- Phone Number
- 858-216-8837
Provider Business Mailing Address Details
- Address
- 751 Orwell St
Lithopolis, OH 43136-9723 - City
- Lithopolis
- State
- OH
- Zip
- 43136-9723
License Information
- License Number (1)
- APRN.CNP.021402
- License State (1)
- OH
- Taxonomy (1)
- Nurse Practitioner, Pediatrics · 363LP0200X
- License Number (2)
- NUR-2023-000730
- License State (2)
- NJ
- Taxonomy (2)
- Nurse Practitioner, Pediatrics · 363LP0200X · Primary
- License Number (3)
- 95022954
- License State (3)
- CA
- Taxonomy (3)
- Nurse Practitioner, Pediatrics · 363LP0200X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Amy M Provenzano, CPNP-PC?
The NPI number of Amy M Provenzano, CPNP-PC is 1487178687. It was assigned on July 28, 2017 and is currently active in the NPPES registry.
What is the specialty of Amy M Provenzano, CPNP-PC?
Amy M Provenzano, CPNP-PC is registered under the primary taxonomy Nurse Practitioner, Pediatrics (code 363LP0200X), licensed in OH under license number APRN.CNP.021402.
Where does Amy M Provenzano, CPNP-PC practice?
The practice location is 67A Mountain Boulevard Ext, 1ST Floor, Unit B, Warren, NJ 07059. The office can be reached at 858-216-8837 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1487178687 directly on the NPPES registry website.