AMANDA ELIZABETH WENNERSTEN FNP
NPI 1386097335
Nurse Practitioner - Family in Phoenix, AZ
Active since July 14, 2016
About Amanda Elizabeth Wennersten Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AMANDA ELIZABETH WENNERSTEN FNP (NPI 1386097335) is an individual family provider in Phoenix, Arizona, licensed in Arizona (AP8586) and active in the NPI registry since July 2016.
NPPES Registry Identity
NPI1386097335
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameAMANDA ELIZABETH WENNERSTENCredential: FNP
Location Address4831 N 11TH STPhoenix, AZ 85014-3681
Mailing Address6015 E Brown RdMesa, AZ 85205-4452 · (480) 325-5869
Phone(602) 424-2101
Fax(602) 424-2103
Sole ProprietorNo
Enumeration DateJuly 14, 2016
Last NPPES UpdateApril 19, 20224 updates tracked since enumeration
NPPES CertifiedApril 19, 2022
✔ NPI 1386097335 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in AZ · AP8586
Also ListedRegistered NurseTaxonomy 163W00000X · License RN164357 (AZ)
4831 N 11TH ST, Phoenix, AZ 85014
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
Nurse Practitioner (Family)
4831 N 11TH ST
PHOENIX, AZ 85014
PHOENIX, AZ 85014
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386097335, enumerated as an "individual" on July 14, 2016.
The provider is located at 4831 N 11TH ST PHOENIX, AZ 85014 and the phone number is (602) 424-2101.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
