Amanda McConville
Nurse Practitioner, Psych/Mental Health in Portage, WI. Individual provider (NPI-1).
NPI number1063259489
StatusActive
Last updated in NPPESMar 27, 2026
Details
- NPI
- 1063259489
- Entity type
- Individual (NPI-1)
- Name
- Amanda McConville
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 12, 2024
- Certification date
- Mar 27, 2026
- Last updated
- Mar 27, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 15536 | WI | Yes |
| 363L00000X | Nurse Practitioner | 15536 | WI |
Practice location
2901 Hunters TrlPortage, WI 53901-3403
Phone 608-742-5518 · Fax 608-268-9780
Mailing address
119 Prairie Heights DrVerona, WI 53593-2333
Phone 608-370-3641
Other practice locations
2702 International Ln Ste 102
Madison, WI 53704-3117
Madison, WI 53704-3117
Phone 608-405-5712 · Fax 608-268-9780
119 Prairie Heights Dr
Verona, WI 53593-2333
Verona, WI 53593-2333
Phone 608-370-3641
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