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General NPI Number Information
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NPI Number | 1871601575
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Entity Type | Individual
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Provider Name | AMIE PENA NP
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Gender | Female
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 01/29/2009
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Provider Practice Location Address
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Address Line | 500 W THOMAS RD SUITE 300
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City | PHOENIX
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State | AZ
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Zip | 85013-4224
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Country | US
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Telephone | 602-406-6262
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Fax | 602-406-6260
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Provider Business Mailing Address
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Address Line | 3200 N CENTRAL AVE 9TH FLOOR
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City | PHOENIX
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State | AZ
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Zip | 85012-2425
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Country | US
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Telephone | 602-406-3729
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Fax | 602-798-9412
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 097145
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License Number State | AZ
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