Amanda June Basham, FNP -BC
NPI #1780326454 in Granite City, Illinois
Provider Information
- NPI Number
- 1780326454
- Entity Type
- Individual
- Name
- Amanda June Basham, FNP -BC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner
- Credential
- FNP -BC
- Enumeration Date
- Apr 12, 2022
- Last Updated
- Apr 12, 2022
Practice Location
- Address
- 3986 MARYVILLE RD
- City
- Granite City
- State
- Illinois
- ZIP Code
- 62040-4191
- Phone
- (618) 797-0618
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
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Organizations
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|---|---|
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