Susannamma Lijan
Nurse Practitioner - Psychiatric/Mental Health
2601 E Roosevelt St
Phoenix
, Arizona 85008-4973
Susannamma Lijan
Nurse Practitioner - Psychiatric/Mental Health
2601 E Roosevelt St
Phoenix
, Arizona 85008-4973
(602) 344-5345
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About
Features
Specialties
- Nurse Practitioner - Psychiatric/Mental Health
Languages spoken
- English
Location
First Address
- Susannamma Lijan
- 2601 E Roosevelt St
- Phoenix, AZ
- Zip : 85008-4973
- Phone : (602) 344-5345
Second Address
- Susannamma Lijan
- 2601 E Roosevelt St
- Phoenix, AZ
- Zip : 85008-4973
- Phone : (602) 344-5345
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 246807 | AZ |
National Provider Identifier
| NPI | 1003424102 |
|---|---|
| Provider Name | Susannamma Lijan |
| First Address | Phoenix, AZ 85008-4973 |
| Second Address | Phoenix, AZ 85008-4973 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/07/2020 |
| Last Update Date | 19/10/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.