AMANDA ELIZABETH WENNERSTEN FNP
NPI 1386097335
Nurse Practitioner - Family in Phoenix, AZ

Q: What is Amanda Wennersten's NPI number?

The NPI number for Amanda Wennersten is 1386097335. It was assigned to this individual provider in the NPPES registry on July 14, 2016.

Q: What is Amanda Wennersten's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Wennersten was last updated on April 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 14, 2016

4831 N 11TH ST, PHOENIX, AZ 85014(602) 424-2101(602) 424-2103 Get Directions Write a Review

NPPES record last updated: April 19, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 19, 2022, Feb 16, 2021, Dec 3, 2019 and 1 more (4 updates tracked since 2016).

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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

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Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELODIE BARILLARO RN

Registered Nurse (General Practice)