Provider Demographics
NPI:1619853496
Name:STENSTROM, AMY LEIGH (MS, CNS, LN)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LEIGH
Last Name:STENSTROM
Suffix:
Gender:F
Credentials:MS, CNS, LN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LEIGH
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5424 ELM GROVE AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55428
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24 3RD ST. NE
Practice Address - Street 2:SUITE C
Practice Address - City:OSSEO
Practice Address - State:MN
Practice Address - Zip Code:55369
Practice Address - Country:US
Practice Address - Phone:763-515-1726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNN254133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist