Provider Demographics
NPI:1154668127
Name:MEHL, AMANDA CATHERINE (MPH, CD(DONA),CLC)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:CATHERINE
Last Name:MEHL
Suffix:
Gender:F
Credentials:MPH, CD(DONA),CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61103-6328
Mailing Address - Country:US
Mailing Address - Phone:314-805-1063
Mailing Address - Fax:
Practice Address - Street 1:309 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61103-6328
Practice Address - Country:US
Practice Address - Phone:314-805-1063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula