NPI 1013611797

Amanda Mae Lorene Fowler Test

Practitioner Community Health Worker Goreville, IL

Practice location

Address: 207 King Cir, Goreville, IL 62939-0020
Phone: (618) 663-8336
Mailing address: 2401 W Main St, Marion, IL 62959-1188

Registered specialties

Community Health Worker Primary

Other Service Providers Taxonomy 172V00000X

Other Community Health Worker providers in Illinois →

Registry record

NPI: 1013611797
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Mar 2023
Record last updated: 28 Mar 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.