Individual
AMANDA K HONCHELL I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
401 W MADISON ST, MOUNT CARROLL, IL 61053-9485
(815) 244-4489
Mailing address
401 W MADISON ST, MOUNT CARROLL, IL 61053-9485
(815) 244-4489
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209018289
IL
363LG0600X
Gerontology Nurse Practitioner
209018289
IL
Other
Enumeration date
02/01/2019
Last updated
02/01/2019
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