MEDICARE: AMANDA GONZALES FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	2018012287	MO
2	363L00000X	Nurse Practitioner	2018012287	MO

General Provider Information

NPI Number	:	1649777848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA GONZALES FNP-BC

Provider Business Mailing Address
First Line	:	660 MASON RIDGE CENTER DR STE 300
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-8512
Country	:	US
Telephone Number	:	314-448-3791
Fax Number	:	314-996-7658

Provider Business Practice Location Address
First Line	:	6261 RONALD REAGAN DR STE B19
Second Line	:
City	:	LAKE SAINT LOUIS
State	:	MO
Zip	:	63367-2665
Country	:	US
Telephone Number	:	636-561-3021
Fax Number	:	636-561-3022

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2018
Last Update Date	:	09/19/2025

Similar Medicare Providers

1699719971 — MS. NANCY S GIAIMO FNP
Practice Location Address:

6261 RONALD REAGAN DR STE B18
LAKE ST LOUIS, MO
63367-2665

Practice Phone: 636-561-3021
Practice Fax:

1770596983 — DR. SCOTT K ROOS MD
Practice Location Address:

6261 RONALD REAGAN DR , STE B19
LAKE ST LOUIS, MO
63367-2665

Practice Phone: 636-561-3021
Practice Fax: 636-561-3022

1326387887 — LISA A SCOTT NP-C
Practice Location Address:

6261 RONALD REAGAN DR STE B19
LAKE SAINT LOUIS, MO
63367-2665

Practice Phone: 636-561-3021
Practice Fax: 636-561-3022

1881020006 — DR. RYAN MICHAEL FAULKNER D.C.
Practice Location Address:

6251 RONALD REAGAN DR
LAKE ST LOUIS, MO
63367-2665

Practice Phone: 636-614-2139
Practice Fax:

1881124311 — CHRISTINA MICHELLE THOMA MD
Practice Location Address:

6261 RONALD REAGAN DR STE B19
LAKE ST LOUIS, MO
63367-2665

Practice Phone: 636-561-3021
Practice Fax:

1205302460 — ADAM LEE TRIMPE FNP-C
Practice Location Address:

6261 RONALD REAGAN DR STE B19
LAKE SAINT LOUIS, MO
63367-2665

Practice Phone: 636-561-3021
Practice Fax:

Directions to “ AMANDA GONZALES FNP-BC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.