Individual
AMANDA LEE TREVINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1540 E EVERGREEN ST, SPRINGFIELD, MO 65803-4300
(417) 823-2900
(417) 886-2774
Mailing address
3183 E LIBERTY ST, REPUBLIC, MO 65738-7826
(417) 755-6486
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2018044128
MO
Other
Enumeration date
01/02/2019
Last updated
08/21/2024
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