Provider Demographics
NPI:1114701406
Name:SCHWANKE, AMY MARIE (APNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:SCHWANKE
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:FAIRBANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 UNIVERSITY AVE E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-2507
Mailing Address - Country:US
Mailing Address - Phone:651-291-2488
Mailing Address - Fax:651-602-6885
Practice Address - Street 1:435 PHALEN BLVD
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-5302
Practice Address - Country:US
Practice Address - Phone:651-291-2848
Practice Address - Fax:651-602-6885
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10359363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily