Individual
AMY B. DOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-4514
(217) 544-6464
Mailing address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-4514
(217) 544-6464
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209005611
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041302470
IL LICENSE #
IL
01
—
0841504038
BLUE CROSS BLUE SHIELD
IL
01
—
209-005611
IL APN LICENSE #
IL
01
—
72797
AANA#
IL
01
—
L031806
CHAMPUS/TRICARE
IL
Enumeration date
10/12/2005
Last updated
12/29/2021
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