IndividualActive
Amanda Mcconville
NPI 1063259489 · Psychiatric/Mental Health Nurse Practitioner · Portage, WI
Provider details
- NPI number
- 1063259489
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 15536 (WI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2901 Hunters Trl
Portage, WI 53901-3403
Phone: (608) 742-5518
Fax: (608) 268-9780
Street-level locationGet directions
Mailing address
119 Prairie Heights Dr
Verona, WI 53593-2333
Additional practice locations (2)
- 2702 International Ln Ste 102Madison, WI 53704-3117Phone: (608) 405-5712Fax: (608) 268-9780
- 119 Prairie Heights DrVerona, WI 53593-2333Phone: (608) 370-3641
Registry dates
- Enumerated
- 2024-07-12
- Last updated
- 2026-03-27
- Certified
- 2026-03-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.