Individual
AMANDA ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1130 W GLENDALE AVE, APPLETON, WI 54914-2344
(920) 750-0167
Mailing address
1130 W GLENDALE AVE, APPLETON, WI 54914-2344
(920) 750-0167
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
176224
WI
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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