Individual provider · Type 1 NPI
Amanda M. Mavis, FNP
Psychiatric/Mental Health Nurse Practitioner · Springfield, IL
NPI number
1396269700
Active
Practice location
3225 Hedley Rd
Springfield, IL 62711-6248
Fax (217) 726-5989
Mailing address
PO Box 3428
Springfield, IL 62708-3428
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 209016157 (IL) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1396269700
Amanda M. Mavis, FNP's National Provider Identifier is 1396269700, issued on Jul 27, 2017. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Springfield, IL. The record was last updated on Jul 27, 2017.