Lavallee, Amanda L

Lavallee, Amanda L is an individual health care provider with primary practice located at 530 Ne Glen Oak Ave , Peoria IL 61637-0001. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care. Physician Assistants & Advanced Practice Nursing Providers / Neonatal is her primary health care specialty. Lavallee, Amanda L can be contacted via phone (309) 655-2000.

Contact Information

Primary practice address
530 Ne Glen Oak Ave Peoria IL 61637-0001
Phone: (309) 655-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 209032798 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care 363LN0005X NP124639 Texas
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 2471949 Idaho

Profile Details

NPI number 1720148091
LBN Legal business name Lavallee, Amanda L
Credentials APRN, CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 9th, 2006
Last updated Sep 9th, 2025 - about last year

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 1720148091 NPPES
Georgia MEDICAID 626130284B

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