Amanda Jean Hennessy, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11258 Issued in MN

Practice address

200 Elm St N
Onamia, MN 56359-7901

Phone

(320) 532-3154

NPI assigned

Feb 2, 2024

Last updated

Feb 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Amanda Jean Zyvoloski Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ahennessy864787@direct.centracare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mille Lacs Health System

  dba Critical Access Hospital

  • Critical Access Hospital
  • Onamia, MN
  • NPI 1548212699
  Medicare reassignment NPD
• Mille Lacs Health System

  dba Mille Lacs Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Onamia, MN
  • NPI 1265695761
  NPD
• Mille Lacs Health System

  dba Mille Lacs Family Health Center

  • Rural Health Clinic/Center
  • Hillman, MN
  • NPI 1326200411
  NPD
• Mille Lacs Health System

  dba Mille Lacs Family Health Center

  • Multi-Specialty Clinic/Center
  • Garrison, MN
  • NPI 1629231121
  NPD
• Mille Lacs Health System

  dba MLHS Community Pharmacy

  • Community/Retail Pharmacy
  • Onamia, MN
  • NPI 1841947801
  NPD
• Mille Lacs Band of Ojibwe Indians

  dba Ne-Ia-Shing Clinic

  • Federally Qualified Health Center (FQHC)
  • Onamia, MN
  • NPI 1740357169
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1518720473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ELM ST N",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "56359",
            "telephone_number": "320-532-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ELM ST N",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563597901",
            "telephone_number": "320-532-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSY",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "11258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "ZYVOLOSKI",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Monica Haglund, CADC 1
• Michelle Marie Hanneken, RN
• Stephanie Ann Hausker, RN
• Rodney Allen Hayes, M.D.
• Casandra Lynn Helmin, BS RN PHN
• Jennifer Lee Hewitt, RN, PHN
• Patti Jean Hook, M.D.
• Kathi Marie Hopkins, HHA
• Donna Lynn Hormillosa, RN
• Ronald John Hunt, MS, LP

• Family Nurse Practitioner in Onamia, MN
• Providers in Onamia, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.