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1780326454
AMANDA JUNE BASHAM
GRANITE CITY, IL
NPI
1780326454
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209025025)
Enumeration Date
2022-04-12
Last Update Date
2022-04-12
Business Address
AMANDA JUNE BASHAM FNP -BC
3986 MARYVILLE RD
GRANITE CITY, IL 62040-4191
Phone number: 618-797-0618
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Mailing Address
AMANDA JUNE BASHAM FNP -BC
3986 MARYVILLE RD
GRANITE CITY, IL 62040-4191
Phone number: 618-797-0618
Copy
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