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
Mailing address420 E Division St, Fond Du Lac, WI 54935-4560

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