NPI | 1891294195 |
---|---|
Professional Name | AMANDA LYNN MUNDINGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209016873) |
Additional Taxonomies | 208D00000X General Practice (Licence: IL 209016873) |
Enumeration Date | 2018-02-02 |
Last Update Date | 2020-08-31 |