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Contact Information

AMANDA S ANDERSON, ANP, FNP-BC
144 OAK HILL DR
MARYVILLE, IL62062-6475
 Phone: 618-520-2159
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for AMANDA S ANDERSON · (Female)

NPI Number 1952797383
Status Active
Credentials ANP, FNP-BC
Entity Individual
Enumeration date 04/13/2015
Last updated 05/26/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 209.012702
  • IL License # 309.008691
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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