AMANDA JUNE BASHAM

GRANITE CITY, IL
NPI1780326454
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IL  209025025)
Enumeration Date2022-04-12
Last Update Date2022-04-12
Business Address
AMANDA JUNE BASHAM FNP -BC
3986 MARYVILLE RD
GRANITE CITY, IL 62040-4191
Phone number: 618-797-0618
Mailing Address
AMANDA JUNE BASHAM FNP -BC
3986 MARYVILLE RD
GRANITE CITY, IL 62040-4191
Phone number: 618-797-0618