Individual
AMANDA M CLOUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
315 W CARPENTER ST FL 1, SPRINGFIELD, IL 62702-4901
(217) 545-8000
(217) 545-1141
Mailing address
PO BOX 19678, SPRINGFIELD, IL 62794-9678
(217) 545-8000
(217) 545-1141
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041430883
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041430883
LICENSE
IL
Enumeration date
05/03/2019
Last updated
05/03/2019
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