Individual
AMANDA LUEBKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-1830
(608) 242-2828
Mailing address
700 S PARK ST, MADISON, WI 53715-1830
(608) 251-6100
(608) 260-2976
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7456-23
WI
363AS0400X
Surgical Physician Assistant
Primary
7456-23
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619600988
—
WI
Enumeration date
07/05/2022
Last updated
09/05/2025
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