SUSANNAMMA LIJAN (NPI# 1003424102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003424102 |
Entity Type | Individual |
Full Name | SUSANNAMMA LIJAN |
Credential | PMHNP |
Practice Address |
2601 E Roosevelt St Phoenix AZ 85008-4973 |
Practice Telephone | 6023445345 |
Mailing Telephone | 6023445345 |
Enumeration Date | 2020-07-15 |
Last Update Date | 2020-10-19 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
246807 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
2601 E ROOSEVELT ST |
City | PHOENIX |
State | AZ |
Zip Code | 85008-4973 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538166152 | Paul Zidel I | Orthopaedic Surgery | 2601 E Roosevelt St, Dept of Surgery, Phoenix, AZ 85008-4973 | 2005-06-29 |
1881293165 | Christina Wellman | Registered Nurse | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-10-19 |
1639786544 | Lindsey Tow | Nurse Anesthetist, Certified Registered | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-09-24 |
1184241705 | Katharine Witham | Anesthesiology | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-06-30 |
1417574435 | Vishal Ravella | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Valleywise Health, Phoenix, AZ 85008 | 2020-06-26 |
1841814894 | Anthony Howard Arnett | Nurse Anesthetist, Certified Registered | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-06-05 |
1053932277 | Bhavesh Shukla | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-04-28 |
1659991016 | Luis Francisco Meza | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-04-25 |
1396365839 | Nicholas Donahue Winter | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-04-24 |
1821618430 | Daniel Glade | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2020-04-23 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821607060 | Am Apnea and Tmj LLC | Durable Medical Equipment & Medical Supplies | 2303 N. 44thst., Suite 14-1008, Phoenix, AZ 85008 | 2020-07-23 |
1194341131 | Abdulbaril Olandapo Olagunju | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt Street, Valleywise Health, Phoenix, AZ 85008 | 2020-06-24 |
1376164632 | Abdul Rahman Raed Mustafa Halawa | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St Valleywise Health, Phoenix, AZ 85008 | 2020-04-28 |
1245869460 | Zachary Masuda | Student in an Organized Health Care Education/Training Program | Valleywise Health Medical Center, 2601 E Roosevelt St, Phoenix, AZ 85008 | 2020-04-08 |
1942840145 | Cana Behavior LLC | Physical Therapist | 2412 N 36 Pl, Phoenix, AZ 85008 | 2020-01-15 |
1871158188 | Fred Gardezy | Student in an Organized Health Care Education/Training Program | Maricopa Integrated Health System 2601 E. Roosevelt St., Phoenix, AZ 85008 | 2019-05-02 |
1225692346 | Navkaran Singh Girgla | Student in an Organized Health Care Education/Training Program | 2601 East Roosevelt St., Phoenix, AZ 85008 | 2019-04-24 |
1316412323 | Southwest Human Developement | Early Intervention Provider Agency | 2850 N 24h Street, Phoenix, AZ 85008 | 2018-10-05 |
1558885970 | Mona Ridhwan Ziems | Midwife | 1919 N 31st St, Phoenix, AZ 85008 | 2017-07-27 |
1093244451 | Shana Cynamon | Audiologist | 1801 N 37th Pl, Phoenix, AZ 85008 | 2017-06-08 |
Find all providers in zip 85008 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215536479 | Yolanda D Baugh | Nurse Practitioner | 2625 W Piedmont Rd, Phoenix, AZ 85041-9540 | 2020-10-20 |
1306450960 | Williamsconsultant Com LLC | Nurse Practitioner | 2303 N 44th St Ste 12-1043, Phoenix, AZ 85008-2442 | 2020-09-01 |
1912515305 | Victory Health Solution LLC | Nurse Practitioner | 9132 W Hubbell St, Phoenix, AZ 85037-4377 | 2020-07-21 |
1700494374 | Vanessa Moe | Nurse Practitioner | 42949 N Voyage Trl, Phoenix, AZ 85086-8040 | 2020-07-20 |
1043838527 | Latasha Lynne Freeman | Nurse Practitioner | 1919 E Thomas Rd Bldg 5th, Phoenix, AZ 85016-7710 | 2020-07-10 |
1861019416 | Gayle Cecilia Bachelier | Nurse Practitioner | 2302 N Central Ave Unit 303, Phoenix, AZ 85004-1373 | 2020-06-30 |
1871119156 | Ashlyn Tellers | Nurse Practitioner | 21438 N 33rd Ave, Phoenix, AZ 85027-2241 | 2020-06-22 |
1770109605 | Hannah Carita Jurekovic-byrd | Nurse Practitioner | 5727 N 7th St Ste 308, Phoenix, AZ 85014-5817 | 2020-06-16 |
1578188025 | Joseph Medlin | Nurse Practitioner | 915 N 52nd St Apt 2010, Phoenix, AZ 85008-7934 | 2020-06-10 |
1750901088 | Foothills Psychiatric Services Pllc | Nurse Practitioner | 3546 E Windmere Dr, Phoenix, AZ 85048-7211 | 2020-04-16 |
Find all providers in PHOENIX |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.