Provider Demographics
NPI:1598226193
Name:HOSEY, AMANDA ANN (AFNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:ANN
Last Name:HOSEY
Suffix:
Gender:
Credentials:AFNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:HOSEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AFNP
Mailing Address - Street 1:576 JAMES DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:IL
Mailing Address - Zip Code:61920-1862
Mailing Address - Country:US
Mailing Address - Phone:217-549-7081
Mailing Address - Fax:
Practice Address - Street 1:576 JAMES DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:IL
Practice Address - Zip Code:61920-1862
Practice Address - Country:US
Practice Address - Phone:217-549-7081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-27
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019151363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily