Individual
AMANDA E ENNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
201 HEALTH CARE DR, GREENVILLE, IL 62246-1155
(618) 664-1380
(618) 664-4239
Mailing address
201 HEALTH CARE DR, GREENVILLE, IL 62246-1155
(618) 664-1380
(618) 664-4239
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.010436
IL
Other
Enumeration date
05/20/2013
Last updated
05/20/2013
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