Individual provider · Type 1 NPI

Amanda Gonzales, FNP-BC

Nurse Practitioner · Lake St. Louis, MO

NPI number 1649777848 Active

Practice location

6261 Ronald Reagan Dr Ste B19
Lake St. Louis, MO 63367-2665

Call (636) 561-3021 Map

Fax (636) 561-3022

Mailing address

660 Mason Ridge Center Dr Ste 300
St. Louis, MO 63141-8512

Specialties and licenses

Taxonomy	Code	License
Family Nurse Practitioner	363LF0000X	2018012287 (MO)
Nurse Practitioner Primary	363L00000X	2018012287 (MO)

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 1649777848

Amanda Gonzales, FNP-BC's National Provider Identifier is 1649777848, issued on Apr 12, 2018. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Lake St. Louis, MO. The record was last updated on Sep 19, 2025.