Individual
MRS. AMANDA M MANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-6864
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-6850
(414) 805-6864
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4909-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003156613
—
WI
Enumeration date
02/18/2013
Last updated
09/27/2019
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