Amanda Agnes Allen, BSW
Individual provider Active NPI Case Manager/Care Coordinator · La Crosse, WI
NPI 1477849321 · NPPES record last updated Jun 20, 2011
Key facts
- NPI
- 1477849321
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- License
- 1704-127 (WI)
- Practice address
- 1407 Saint Andrew St Ste 100
La Crosse, WI 54603-2378 - Phone
- (608) 789-4894
- Fax
- (608) 785-6315
- NPI assigned
- Jun 20, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1704-127 | WI | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Crosse County Cmo | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 1704-127 | WI | Yes |
Addresses
Primary practice location
1407 Saint Andrew St Ste 100
La Crosse, WI 54603-2378
Mailing address
1914 30TH St S
La Crosse, WI 54601-6908
Phone (608) 799-5963
Other providers in La Crosse, WI
- Ronald Alexander II
- Mareah Alexander
- Christian Alfaro
- Christine R Alioto
- Mariah Allard
- Brian Kenelm Allen
- Eugena Allen
- Tara Lynn Allert
- Bobbi Mackenzie Allison
- Heidi B Allred
All providers in La Crosse, WI · Case Manager/Care Coordinator in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.