Individual
LAURA J. AMIDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
221 N LAFAYETTE ST, MOUNT PULASKI, IL 62548-1231
(217) 792-5375
Mailing address
221 N LAFAYETTE ST, MOUNT PULASKI, IL 62548-1231
(217) 792-5375
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209-000540
IL
363LF0000X
Family Nurse Practitioner
Primary
277000386
IL
Other
Enumeration date
09/26/2006
Last updated
01/21/2025
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