Individual
SUSANNAMMA LIJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
6850 W INDIAN SCHOOL RD, PHOENIX, AZ 85033-3300
(623) 469-1331
Mailing address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5345
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
246807
AZ
Other
Enumeration date
07/15/2020
Last updated
04/02/2025
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