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

Jennifer Leigh Hanisch, AGACNP

Individual provider Nurse Practitioner · NPI 1124667175

Jennifer Leigh Hanisch, AGACNP is a Nurse Practitioner in Phoenix, Arizona. Qualified in 2019, 7 years ago. Practices with Banner - University Physician Specialists LLC, a 347-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
7
Licensed in
AZ
In the registry since
2019
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Practice location Address checks out

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone: (602) 839-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence PENDING (AZ)

Record details

NPI number1124667175
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedDecember 21, 2019
Last updated in NPPESAugust 20, 2021
Certification dateAugust 2, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Banner - University Physician Specialists Llc — 347 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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