Amanda Marie Allen, PA-C
Physician Assistant in Peoria, IL. Individual provider (NPI-1).
NPI number1376829010
StatusActive
Last updated in NPPESApr 4, 2023
Details
- NPI
- 1376829010
- Entity type
- Individual (NPI-1)
- Name
- Miss Amanda Marie Allen
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 26, 2011
- Certification date
- Apr 4, 2023
- Last updated
- Apr 4, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085.004220 | IL | Yes |
Other names
- Amanda Marie Crawford (Former Name)
Practice location
8600 N State Route 91Suite 300
Peoria, IL 61615-9541
Phone 309-691-6616 · Fax 309-691-2943
Mailing address
2401 W Alta RdApt. 1904
Peoria, IL 61615-1279
Phone 219-508-5791
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