Individual
AMANDA M EVERSGERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 PROFESSIONAL PARK DR, MARYVILLE, IL 62062-5830
(618) 531-5802
Mailing address
152 FOREST OAKS DR, CASEYVILLE, IL 62232-2847
(618) 531-5802
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.019216
IL
Other
Enumeration date
04/04/2019
Last updated
04/04/2019
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