Individual provider · Type 1 NPI

Amanda Rose Bantle, APNP

Nurse Practitioner · Green Bay, WI

NPI number 1003520495 Active

Practice location

2581 Development Dr
Green Bay, WI 54311-4247

Call (920) 347-0400 Map

Fax (920) 347-0868

Mailing address

1035 Kepler Dr
Green Bay, WI 54311-8320

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X168768-30 (WI)
Nurse Practitioner Primary 363L00000X13516-33 (WI)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1003520495

Amanda Rose Bantle, APNP's National Provider Identifier is 1003520495, issued on Jan 10, 2023. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Green Bay, WI. The record was last updated on Apr 21, 2026.