Individual
AMANDA L EALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3301 BROADWAY ST, QUINCY, IL 62301-3713
(217) 277-4090
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801-2500
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209024702
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041421090
RN
IL
Enumeration date
01/06/2022
Last updated
03/18/2025
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