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Individual

AMANDA ELIZABETH WENNERSTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
4831 N 11TH ST, PHOENIX, AZ 85014-3681
(602) 424-2101
(602) 424-2103
Mailing address
6015 E BROWN RD, MESA, AZ 85205-4452
(480) 325-5869

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN164357
AZ
363LF0000X
Family Nurse Practitioner
Primary
AP8586
AZ

Other

Enumeration date
07/14/2016
Last updated
04/19/2022
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