Individual
AMANDA C LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1301 S KOKE MILL RD, SPRINGFIELD, IL 62711-9252
(217) 547-9230
(217) 547-9236
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-7578
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.432814
IL
363L00000X
Nurse Practitioner
Primary
209021451
IL
Other
Enumeration date
09/23/2020
Last updated
05/03/2021
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