Healthcare Provider Details

I. General information

NPI: 1790507754
Provider Name (Legal Business Name): JENNIFER CHRISTINE AMAYA APRN, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2024
Last Update Date: 07/14/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N CAMPBELL AVE
TUCSON AZ
85719-4330
US

IV. Provider business mailing address

16011 CAMINO CASAL
SAHUARITA AZ
85629-7610
US

V. Phone/Fax

Practice location:
  • Phone: 505-850-7840
  • Fax:
Mailing address:
  • Phone: 505-850-7840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberRN214656
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number1
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: