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General NPI Number Information
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NPI Number | 1710714258
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Entity Type | Individual
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Provider Name | AMANDA ROSE GRESSEL FNP
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Gender | Female
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Dates
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Enumeration Date | 09/18/2024
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 2162 E WILLIAMS FIELD RD STE 111
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City | GILBERT
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State | AZ
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Zip | 85295-0736
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Country | US
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Telephone | 480-795-1515
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Fax |
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Provider Business Mailing Address
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Address Line | 3030 N CENTRAL AVE STE 1200
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City | PHOENIX
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State | AZ
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Zip | 85012-2745
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Country | US
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Telephone | 480-607-0606
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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 | 315555
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163WR0400X
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Taxonomy Name | Rehabilitation Registered Nurse
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License Number | 152882
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License Number State | AZ
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