Amanda E Ennen, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.010436 Issued in IL

Practice address

201 Health Care Dr
Greenville, IL 62246-1155

Phone

(618) 664-1380

Fax

(618) 664-4239

NPI assigned

May 20, 2013

Last updated

May 20, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1881030682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HEALTH CARE DR",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622461155",
            "telephone_number": "618-664-1380",
            "fax_number": "618-664-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HEALTH CARE DR",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622461155",
            "telephone_number": "618-664-1380",
            "fax_number": "618-664-4239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNEN",
        "first_name": "AMANDA",
        "middle_name": "E",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-20",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.010436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asim Elmahboub, M.D.
• Emerald Glen Managment
• Noah Emerick
• Christopher Engele
• Jill Renee Engelmann, LCSW
• Austin James Fairchild, MFT
• Family Eye Care Association, P.C.
• Hana Filipova, M.D.
• Christy Leann Forbes, FNP
• Christopher Frantz, M.D.

• Family Nurse Practitioner in Greenville, IL
• Providers in Greenville, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.