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General NPI Number Information
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NPI Number | 1962831511
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Entity Type | Individual
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Provider Name | AMANDA LEIGH RYAN APN
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Gender | Female
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Dates
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Enumeration Date | 11/04/2013
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 3426 N PORT DR STE 200
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City | MUSCATINE
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State | IA
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Zip | 52761-2242
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Country | US
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Telephone | 563-263-2724
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Fax |
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Provider Business Mailing Address
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Address Line | 3155 62ND AVE
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City | NEW WINDSOR
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State | IL
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Zip | 61465-9361
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Country | US
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Telephone | 309-737-3758
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | H154347
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 277.002465
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License Number State | IL
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