MEDICARE: EMILY AMENYA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	26NJ00566400	NJ
2	363LF0000X	Family Nurse Practitioner	AP61206545	WA
3	363LF0000X	Family Nurse Practitioner	202104356NP-PP	OR
4	363LF0000X	Family Nurse Practitioner	95018309	CA
5	363LF0000X	Family Nurse Practitioner	AP134398	TX

General Provider Information

NPI Number	:	1891168258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY AMENYA

Provider Business Mailing Address
First Line	:	22 CENTURY BLVD STE 220
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-3787
Country	:	US
Telephone Number	:	615-346-8468
Fax Number	:	855-737-5542

Provider Business Practice Location Address
First Line	:	5444 WESTHEIMER RD STE 1000
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-5318
Country	:	US
Telephone Number	:	832-786-4970
Fax Number	:	855-737-5542

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2015
Last Update Date	:	06/22/2023

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Directions to “ EMILY AMENYA ” Practice Location

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