Individual
AMANDA SHIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
918 EMBER LN, SPRING GROVE, IL 60081-8291
(505) 930-0543
Mailing address
918 EMBER LN, SPRING GROVE, IL 60081-8291
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041490532
IL
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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