Basic Information
| Provider Information | |||||||||
| NPI: | 1083015689 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMASON | ||||||||
| FirstName: | NATALIE | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 CARLSON PKWY N STE 240 | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554474485 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7637460030 | ||||||||
| FaxNumber: | 7633677977 | ||||||||
| Practice Location | |||||||||
| Address1: | 4107 S WATER TOWER PL | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 62864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6182440031 | ||||||||
| FaxNumber: | 6182440056 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2014 | ||||||||
| LastUpdateDate: | 03/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 209017899 | IL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | 209.017899 | IL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 207N00000X | 209017899 | IL | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.