Healthcare Provider Details

I. General information

NPI: 1306211214
Provider Name (Legal Business Name): AMY FIEDLER-KITCHEN AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY FUSCO RN

II. Dates (important events)

Enumeration Date: 12/03/2015
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22455 N MILLER RD STE B100
SCOTTSDALE AZ
85255-4956
US

IV. Provider business mailing address

22455 N MILLER RD STE B100
SCOTTSDALE AZ
85255-4956
US

V. Phone/Fax

Practice location:
  • Phone: 480-435-9100
  • Fax: 480-702-0083
Mailing address:
  • Phone: 480-435-9100
  • Fax: 480-702-0083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number313024
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP015575
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: