Healthcare Provider Details

I. General information

NPI: 1003481847
Provider Name (Legal Business Name): JENNIFER CHRISTINE FENDLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11624 E SHEA BLVD
SCOTTSDALE AZ
85259-5111
US

IV. Provider business mailing address

22702 N 39TH TER
PHOENIX AZ
85050-5408
US

V. Phone/Fax

Practice location:
  • Phone: 480-798-3660
  • Fax: 480-302-8573
Mailing address:
  • Phone: 602-799-3728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number257625
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: