AMY MICHELLE PROVENZANO Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADVANCED PRACTICE REGISTERED NURSE

License Number

209029381

License Status

ACTIVE

Business

First Name

AMY

Middle

MICHELLE

Last Name

PROVENZANO

Business Name

AMY MICHELLE PROVENZANO

Original Issue Date

03/06/2024

Effective Date

03/06/2024

Expiration Date

05/31/2026

City

LITHOPOLIS

State

Zip

43136

Ever Disciplined

LastModifiedDate

03/02/2026