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General NPI Number Information
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NPI Number | 1861702532
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Entity Type | Individual
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Provider Name | AMANDA K PRATHER ACNS-BC
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Gender | Female
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Dates
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Enumeration Date | 10/15/2010
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 106 S 1ST ST STE 100
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City | FAIRBURY
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State | IL
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Zip | 61739-1509
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Country | US
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Telephone | 815-692-2308
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Fax |
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Provider Business Mailing Address
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Address Line | 540 W NORTH ST STE 206207
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City | MANHATTAN
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State | IL
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Zip | 60442-8201
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Country | US
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Telephone | 815-478-7866
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 277001882
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | 18259
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | 277001882
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License Number State | IL
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