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1396269700
AMANDA M MAVIS
SPRINGFIELD, IL
NPI
1396269700
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: IL 209016157)
Enumeration Date
2017-07-27
Last Update Date
2017-07-27
Business Address
AMANDA M MAVIS FNP
3225 HEDLEY RD
SPRINGFIELD, IL 62711-6248
Phone number: 217-726-7300
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Mailing Address
AMANDA M MAVIS FNP
PO BOX 3428
SPRINGFIELD, IL 62708-3428
Phone number: 800-577-5368
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