Individual
AMANDA GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
6261 RONALD REAGAN DR STE B19, LAKE SAINT LOUIS, MO 63367-2665
(636) 561-3021
(636) 561-3022
Mailing address
660 MASON RIDGE CENTER DR STE 300, SAINT LOUIS, MO 63141-8512
(314) 448-3791
(314) 996-7658
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2018012287
MO
363LF0000X
Family Nurse Practitioner
2018012287
MO
Other
Enumeration date
04/12/2018
Last updated
09/19/2025
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