Individual
AMANDA UMNUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
12500 AURORA DR, PLEASANT PRAIRIE, WI 53158-1227
(262) 857-5000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5286
WI
363LA2200X
Adult Health Nurse Practitioner
5286-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100029836
—
WI
05
—
1619311040
—
WI
Enumeration date
04/29/2013
Last updated
03/27/2025
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