Organization Active NPI

Amanda Lebrija Hernandez FNP C MSN LLC

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1811255508
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP4460 Issued in AZ
Legal business name
AMANDA LEBRIJA HERNANDEZ FNP C MSN LLC
Practice address
3600 W Orange Grove Rd # 34
Tucson, AZ 85741-2824
Phone
(520) 297-3907
Fax
(520) 989-3486
NPI assigned
May 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Authorized official

Name
Mrs. Amanda Lebrija Hernandez, FNP C MSNNPI 1598023913
Title
Owner
Phone
(520) 297-3907

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X AP4460 AZ Primary

Addresses

Primary practice location

3600 W Orange Grove Rd # 34
Tucson, AZ 85741-2824

Mailing address

PO Box 36627
Tucson, AZ 85740-6627
Phone (520) 297-3907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120907000343 AZ Part B Supplier - Clinic/Group Practice 1658529102 Receives reassigned benefits from 1 practitioner
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory

Locations

3600 W Orange Grove Rd
#34
Tucson, AZ 85741
Phone (520) 297-3907

3600 W Orange Grove Rd
#138
Tucson, AZ 85741
Phone (520) 297-3907

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368057600000",
    "number": "1811255508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36627",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857406627",
            "telephone_number": "520-297-3907",
            "fax_number": "520-989-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W ORANGE GROVE RD # 34",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857412824",
            "telephone_number": "520-297-3907",
            "fax_number": "520-989-3486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA LEBRIJA HERNANDEZ FNP C MSN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-01",
        "last_updated": "2013-05-09",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "LEBRIJA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-297-3907",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP C MSN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.