Halvorson, Amanda Lynn

Halvorson, Amanda Lynn is an sole proprietor health care provider with primary practice located at 5970 Churchview Dr , Rockford IL 61107-2574. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Allopathic & Osteopathic Physicians / General Practice. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Halvorson, Amanda Lynn can be contacted via phone (815) 971-2000.

Contact Information

Primary practice address
5970 Churchview Dr Rockford IL 61107-2574
Phone: (815) 971-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209016873 Illinois
Allopathic & Osteopathic Physicians / General Practice 208D00000X 209016873 Illinois

Profile Details

NPI number 1891294195
LBN Legal business name Halvorson, Amanda Lynn
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 2nd, 2018
Last updated Aug 31st, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891294195 NPPES
Wisconsin MEDICAID 1891294195

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