Individual
AMANDA JO GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2001 PHILO RD, URBANA, IL 61802-8007
(217) 552-1211
(217) 398-9077
Mailing address
2001 PHILO RD, URBANA, IL 61802-8007
(217) 398-9066
(217) 398-9077
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209020850
IL
Other
Enumeration date
08/10/2020
Last updated
07/08/2024
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