Healthcare Provider Details

I. General information

NPI: 1447523253
Provider Name (Legal Business Name): AMANDA MONSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2012
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 W DAYTON ST
MADISON WI
53703-1967
US

IV. Provider business mailing address

545 W DAYTON ST
MADISON WI
53703-1967
US

V. Phone/Fax

Practice location:
  • Phone: 608-663-8424
  • Fax:
Mailing address:
  • Phone: 608-663-8424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number128371-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: