Individual
AMANDA L LAVALLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
209032798
IL
363LN0000X
Neonatal Nurse Practitioner
2471949
ID
363LN0005X
Critical Care Neonatal Nurse Practitioner
NP124639
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
626130284B
—
GA
Enumeration date
12/09/2006
Last updated
09/09/2025
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