NPI 1083963219

Amanda Sue Molback, NP

Practitioner Nurse Practitioner Menomonie, WI

Practice location

Address: 2321 Stout Rd, Menomonie, WI 54751-7003
Phone: (715) 235-5531
Fax: (715) 233-7645
Mailing address: 200 1st St SW, Rochester, MN 55905-0002

Registered specialties

Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363L00000X Licence 4987-33 (WI)

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Registry record

NPI: 1083963219
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Sep 2012
Record last updated: 16 Feb 2021

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.