JEANINE LUTGEN (NPI# 1609936772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609936772 |
| Entity Type | Individual |
| Full Name | JEANINE LUTGEN |
| Credential | PA-C |
| Practice Address |
4521 W Hopi Trl Laveen AZ 85339-2068 |
| Mailing Address |
Po Box 436 Laveen AZ 85339-0436 |
| Practice Telephone | 6027953371 |
| Mailing Telephone | 6027953371 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2019-04-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
3608 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 284600 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9201 W Thomas Rd, Phoenix, AZ 850373332 | 6233274000 | |
| 6750 E Baywood Ave, Mesa, AZ 852061749 | 4808545000 | |
| 5555 W Thunderbird Rd, Glendale, AZ 853064622 | 6028655555 | |
| 1955 W Frye Rd, Chandler, AZ 852246282 | 4897283000 | |
| 1400 S Dobson Rd, Mesa, AZ 852024707 | 4805123000 | |
| 1930 E Thomas Rd, Phoenix, AZ 850167711 | 6025321000 | |
| 18701 N 67th Ave, Glendale, AZ 853087100 | 6235611000 | |
| 13677 W Mcdowell Rd, Goodyear, AZ 853952635 | 6238821500 | |
| 10401 W Thunderbird Blvd, Sun City, AZ 853513004 | 6239977211 | |
| 8144 E Cactus Rd, Suite 800, Scottsdale, AZ 852605266 | 4805968525 | 4804786628 |
| Street Address |
4521 W HOPI TRL |
| City | LAVEEN |
| State | AZ |
| Zip Code | 85339-2068 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831353382 | Jdl-ctspa | Physician Assistant | 4521 W Hopi Trl, Laveen, AZ 85339-2068 | 2008-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093351611 | Nationwide Vision Center, LLC | Technician/Technologist | 7650 S 59th Ave, Suite 101, Laveen, AZ 85339 | 2019-11-19 |
| 1164074282 | Alvis Lee Robertson | Counselor | 3850 N. 16th St. E. Beltline Rd., Laveen, AZ 85339 | 2019-07-09 |
| 1912493933 | Kristine Robles | Specialist/Technologist | 6501 W Alta Vista Rd, Laveen, AZ 85339 | 2018-07-02 |
| 1366968521 | Care Line, LLC | Home Health | 5818 West Pedro Lane, Laveen, AZ 85339 | 2017-08-19 |
| 1881119550 | Calvary Home Care Services Inc | Day Training, Developmentally Disabled Services | 4360 W. Alta Vista Rd, Laveen, AZ 85339 | 2017-08-03 |
| 1295284354 | Brian Hiapo Jr. | Assistant, Podiatric | 6170 S 51st Ave Ste 103, Laveen, AZ 85339 | 2016-09-29 |
| 1962850073 | Laveen Pediatric Dental Partners, LLP | Dentist | 5235 W. Baseline Rd, Ste 187, Laveen, AZ 85339 | 2016-05-31 |
| 1619353992 | Tiffany Lee | Specialist/Technologist | 7034 S. 64ave, Laveen, AZ 85339 | 2015-08-10 |
| 1558759068 | Makoto Wakamori | Counselor | 3850 North 16th Street Laveen Az 85339, Laveen, AZ 85339 | 2015-01-06 |
| 1568850329 | Gila River Health Care Corporation | Community Based Residential Treatment Facility, Mental Illness | 142226 S 53rd Ave, Laveen, AZ 85339 | 2015-01-02 |
| Find all providers in zip 85339 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831353382 | Jdl-ctspa | Physician Assistant | 4521 W Hopi Trl, Laveen, AZ 85339-2068 | 2008-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760030647 | Blaine Wesley Price | Physician Assistant | 796 W Jardin Dr, Casa Grande, AZ 85122-6162 | 2019-09-03 |
| 1790347292 | James M Goldhardt | Physician Assistant | 1400 S Dobson Rd Ste A200, Mesa, AZ 85202-4707 | 2019-07-03 |
| 1972166858 | Red Heart Surgical Assisting | Physician Assistant | 43643 W Arizona Ave, Maricopa, AZ 85138-5642 | 2019-04-17 |
| 1053898833 | Sportsmedicine Outreach Specialist | Physician Assistant | 13247 N 80th Pl, Scottsdale, AZ 85260-4903 | 2018-07-24 |
| 1912496712 | Hw Surgical Assist, Pllc | Physician Assistant | 4057 E Laurel Ave, Gilbert, AZ 85234 | 2018-05-07 |
| 1346741501 | Coraesthetics Pllc | Physician Assistant | 2008 E Laguna Dr, Tempe, AZ 85282 | 2018-02-23 |
| 1366955155 | Jennifer R Osborne | Physician Assistant | 100 S Eastern Dawn Ave, Tucson, AZ 85748-1708 | 2017-11-15 |
| 1669985198 | Jacki Nichols | Physician Assistant | 5055 N Rock Canyon Rd, Tucson, AZ 85750-6003 | 2017-11-06 |
| 1720597214 | Merieme Khamsi | Physician Assistant | 14674 W Mountain View Blvrd #210, Surprise, AZ 85374 | 2017-09-27 |
| 1801305073 | Panduga Surgical Care, Pllc | Physician Assistant | 4904 S Power Rd Ste 103, Pmb 450, Mesa, AZ 85212-3610 | 2017-09-20 |
| Find all providers with the same taxonomy | ||||
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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.