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NPI Code Detail

MEDICARE: AMANDA S DALASKA ARNP

MEDICARE: AMANDA S DALASKA ARNP
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
1363LF0000XFamily Nurse PractitionerA122875IA
2363LF0000XFamily Nurse Practitioner277003813IL

General Provider Information

NPI Number : 1962750422
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA S DALASKA ARNP
Provider Business Mailing Address
First Line : PO BOX 4028
Second Line :
City : ROCK ISLAND
State : IL
Zip : 61204-4028
Country : US
Telephone Number : 563-355-9200
Fax Number : 563-355-3419
Provider Business Practice Location Address
First Line : 221 MAIN AVE
Second Line :
City : CLINTON
State : IA
Zip : 52732-2241
Country : US
Telephone Number : 563-242-7522
Fax Number : 563-242-7534
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2012
Last Update Date : 04/02/2026

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