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General NPI Number Information
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NPI Number | 1316754534
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Entity Type | Individual
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Provider Name | AMANDA SUE NANCE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 3811 E BELL RD STE 111
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City | PHOENIX
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State | AZ
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Zip | 85032-2158
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Country | US
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Telephone | 602-675-2585
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Fax |
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Provider Business Mailing Address
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Address Line | 36608 N SIERRA VISTA DR
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85140-9172
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Country | US
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Telephone | 480-427-9331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F12240268
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License Number State | AZ
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