Healthcare Provider Details

I. General information

NPI: 1619853496
Provider Name (Legal Business Name): AMY LEIGH STENSTROM MS, CNS, LN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY LEIGH BARNETT

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5424 ELM GROVE AVE
NEW HOPE MN
55428-3841
US

IV. Provider business mailing address

5424 ELM GROVE AVENUE
NEW HOPE MN
55428
US

V. Phone/Fax

Practice location:
  • Phone: 763-515-1726
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberN254
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: