Individual
MS. AMANDA SUE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP, FNP-BC
Contact information
Practice address
144 OAK HILL DR, MARYVILLE, IL 62062-6475
(618) 520-2159
Mailing address
12 N 64TH ST, BELLEVILLE, IL 62223-3809
(618) 397-0900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209.012702
IL
363LF0000X
Family Nurse Practitioner
309.008691
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
309.008691
IL
Other
Enumeration date
04/13/2015
Last updated
05/26/2021
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