Provider Demographics
NPI:1730700923
Name:STURGEON, AMANDA D (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:D
Last Name:STURGEON
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:CIMARRON
Mailing Address - State:NM
Mailing Address - Zip Code:87714-5002
Mailing Address - Country:US
Mailing Address - Phone:719-859-5486
Mailing Address - Fax:
Practice Address - Street 1:3720 SINTON RD STE 104
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-5085
Practice Address - Country:US
Practice Address - Phone:719-493-9555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-29
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1627220163W00000X, 163WS0200X
NM60732363LP0808X
COC-APN.0103846-C-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool