Individual
AMANDA F GOPLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 263-6400
(608) 833-6965
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
119966
IA
163W00000X
Registered Nurse
191157-30
WI
363LF0000X
Family Nurse Practitioner
2012005964
MD
363LF0000X
Family Nurse Practitioner
Primary
4924-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366798902
BCBSWI
WI
05
—
1366798902
—
WI
01
—
GOPLEAMA
MERCYCARE INSURANCE
WI
Enumeration date
08/01/2012
Last updated
01/07/2021
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