Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Miss. Amanda Catherine Fraser, PA-C

Individual provider Physician Assistant · NPI 1609619691

Miss. Amanda Catherine Fraser, PA-C is a Physician Assistant in Rockford, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1100 Broadway
Rockford, IL 61104-1429
Phone: (815) 490-1600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085.010647 (IL)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1609619691
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 17, 2024
Last updated in NPPESOctober 30, 2025
Certification dateOctober 30, 2025

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