Healthcare Provider Details

I. General information

NPI: 1821440538
Provider Name (Legal Business Name): AMANDA D ENIX NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 HOSPITAL DR STE 1620
TOLEDO OH
43614-8001
US

IV. Provider business mailing address

3000 ARLINGTON AVE # MS 1108
TOLEDO OH
43614-2595
US

V. Phone/Fax

Practice location:
  • Phone: 419-383-6105
  • Fax:
Mailing address:
  • Phone: 419-383-5322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN.367274
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.019686
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: