Individual
MRS. AMANDA VICENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
1720 TAM O SHANTER TRL, SUN PRAIRIE, WI 53590-9517
(920) 327-1743
Mailing address
1720 TAM O SHANTER TRL, SUN PRAIRIE, WI 53590-9517
(920) 327-1743
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
223036-30
WI
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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