Lange, Amanda C

Lange, Amanda C is an individual health care provider with primary practice located at 2321 Stout Road , Menomonie WI 54751-7003. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Lange, Amanda C can be contacted via phone (715) 838-5222.

Contact Information

Primary practice address
2321 Stout Road Menomonie WI 54751-7003
Phone: (715) 838-5222
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085.004518 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3709-23 Wisconsin

Profile Details

NPI number 1295088821
LBN Legal business name Lange, Amanda C
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2012
Last updated Dec 18th, 2023 - 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 1295088821 NPPES
Wisconsin MEDICAID 1295088821

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