Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amy E Fannin, APNP

Individual provider Adult Health Nurse Practitioner · NPI 1093124265

Amy E Fannin, APNP is a Nurse Practitioner in Fond Du Lac, Wisconsin. Qualified in 2014, 12 years ago. Practices with Agnesian Healthcare Inc, a 390-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
12
Licensed in
WI
In the registry since
2014
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Practice location Address checks out

430 E Division St
Fond Du Lac, WI 54935-4560
Phone: (920) 926-4530
Fax: (920) 926-8953
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 5904-33 (WI)

Record details

NPI number1093124265
Entity typeIndividual (Type 1)
GenderFemale
Credentials APNP
Sole proprietorNo
NPI enumeratedAugust 12, 2014
Last updated in NPPESDecember 21, 2020
Certification dateDecember 21, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Agnesian Healthcare Inc — 390 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Fond Du Lac