Individual
AMANDA DAWN RITA CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
123 25TH AVE, ALTOONA, PA 16601-3919
(814) 931-4817
Mailing address
123 25TH AVE, ALTOONA, PA 16601-3919
(814) 931-4817
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN292628
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05171992
DOB
—
Enumeration date
11/01/2021
Last updated
05/11/2026
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