Provider Demographics
NPI:1710320528
Name:ZEHNER, AMANDA L (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:ZEHNER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:L
Other - Last Name:HETTINGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-0463
Mailing Address - Fax:
Practice Address - Street 1:460 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-0463
Practice Address - Fax:614-293-3193
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.14434363L00000X
OHCOA.14434-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0089086Medicaid