person
Amanda M Mavis, FNP
Psychiatric/Mental Health Nurse Practitioner in Springfield, Illinois
NPI 1396269700

Amanda M Mavis is a Psychiatric/Mental Health Nurse Practitioner based in Springfield, IL and is specialized in Psychiatric/Mental Health. Amanda M Mavis practices in Springfield, IL and has the professional credentials of FNP. The NPI Number for Amanda M Mavis is 1396269700 and holds a License No. 209016157 (Illinois).

The current practice location address for Amanda M Mavis is 3225 Hedley Rd, Springfield, IL and can be reached out via phone at 217-726-7300 and via fax at 217-726-5989. You can also correspond with Amanda M Mavis through the mailing address at PO BOX 3428, SPRINGFIELD, IL - 62708-3428 (mailing address contact number: 800-577-5368).

Location: 3225 Hedley Rd, Springfield, IL, 62708-3428
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Provider Profile Details
NPI Number
1396269700
Provider Name
Amanda M Mavis
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
3225 Hedley Rd, Springfield, IL, 62708-3428
Phone Number
217-726-7300
Fax Number
217-726-5989
Provider Enumeration Date
07/27/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2017014688 01 IL MHFNP CERTIFICATION
institution
Provider Business Practice Location Address Details
Address
3225 Hedley Rd
City
State
Zip
62711-6248
Phone Number
217-726-7300
Fax Number
217-726-5989
person
Provider Business Mailing Address Details
Address
Po Box 3428
City
State
Zip
62708-3428
Phone Number
800-577-5368
Fax Number
217-757-2021
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
209016157 (Illinois)
Definition
Definition to come...
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