Individual provider · Type 1 NPI
Ami Mantych, APNP
Family Nurse Practitioner · Beaver Dam, WI
NPI number
1417818030
Active · reactivated Aug 21, 2026
Practice location
707 S University Ave
Beaver Dam, WI 53916-3027
Mailing address
W9675 Cousins Ct
Beaver Dam, WI 53916-9242
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 18755-33 (WI) |
| Family Medicine Physician | 207Q00000X | 164101 (WI) |
Family Nurse Practitioner: Definition to come...
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Other family nurse practitioner providers in Beaver Dam
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About NPI 1417818030
Ami Mantych, APNP's National Provider Identifier is 1417818030, issued on Nov 21, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Beaver Dam, WI. The record was last updated on Aug 26, 2026.