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Search › Wisconsin › 225200000X

Amanda Waller

NPI 1134504657 · on the registry since 2015

Practice

Address
19 W Newton St
Rice Lake, WI 54868
Phone
(715) 234-2161
Organisation at this address
First American Enterprises, Inc
Heritage Rice Lake Operations Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
5

Registry record

Primary taxonomy
225200000X
225200000X
Licence states on file
WI
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2015-07-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin