Individual
AMANDA J BEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23 TERRE VERTE CT, SAINT CHARLES, MO 63304-1217
(716) 228-0524
Mailing address
23 TERRE VERTE CT, SAINT CHARLES, MO 63304-1217
(716) 228-0524
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2020003743
MO
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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