Provider Demographics
NPI:1023731916
Name:CAPUTO, AMANDA RAE (APRN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:RAE
Last Name:CAPUTO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3460 MEANDERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9616
Mailing Address - Country:US
Mailing Address - Phone:330-720-4292
Mailing Address - Fax:
Practice Address - Street 1:970 WINDHAM CT STE 6A
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5082
Practice Address - Country:US
Practice Address - Phone:330-259-0440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0032381363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner