Individual
MS. AMANDA MARIA LANTOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1641 N ALPINE RD STE 207, ROCKFORD, IL 61107-1458
(630) 974-6602
Mailing address
8913 HIGHLAND OAKS DR, JOHNSTON, IA 50131-2225
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
125412
IA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
125412
IA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G160765
IA
Other
Enumeration date
09/10/2020
Last updated
08/30/2024
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