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Individual
AMANDA ALLEN
Active
Individual
AMANDA ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
28157233A
IN
163WG0000X
General Practice Registered Nurse
041360704
IL
363LA2100X
Acute Care Nurse Practitioner
209028603
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
71016593A
IN
Other
Enumeration date
09/04/2023
Last updated
05/28/2025
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