KAREN LYNN MODRZEJEWSKI (NPI# 1831491059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1831491059 |
Entity Type | Individual |
Full Name | KAREN LYNN MODRZEJEWSKI |
Credential | PMHNP-BC |
Practice Address |
630 N Alvernon Way Tucson AZ 85711 |
Mailing Address |
973 E Josephine Saddle Pl Green Valley AZ 85614-6300 |
Practice Telephone | 5203274505 |
Mailing Telephone | 5203428395 |
Enumeration Date | 2010-11-19 |
Last Update Date | 2018-08-29 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163W00000X | Registered Nurse | 114985 | AZ | Nursing Service Providers |
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
10946 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
630 N ALVERNON WAY |
City | TUCSON |
State | AZ |
Zip Code | 85711 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730189655 | James M Gillard | Emergency Medicine | 630 N Alvernon Way, Suite 250, Tucson, AZ 85711-1843 | 2005-07-21 |
1720568223 | Mary Elizabeth Hunter | Counselor | 630 N Alvernon Way, Tucson, AZ 85711-1843 | 2018-08-15 |
1770070732 | Andrew Ryan Dorsett | Registered Nurse | 630 N Alvernon Way, Tucson, AZ 85711-1843 | 2018-04-16 |
1417463316 | Wade Arden Vero Gage | Social Worker | 630 N Alvernon Way, Tucson, AZ 85711-1843 | 2017-12-14 |
1598201295 | Jessica Ganz | Nurse Practitioner | 630 N Alvernon Way, Suite 250, Tucson, AZ 85711-1843 | 2017-01-18 |
1396105797 | Smsj Tucson Holdings, LLC | Radiology | 630 N Alvernon Way, Suite 150, Tucson, AZ 85711-1843 | 2016-02-26 |
1336556596 | Ronald A. Kline, Md., PC | Surgery | 630 N Alvernon Way, Suite 180, Tucson, AZ 85711-1843 | 2014-07-18 |
1174862007 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 630 N Alvernon Way, Ste 161, Tucson, AZ 85711-1843 | 2013-02-13 |
1639416084 | Genoa Healthcare, LLC | Pharmacy | 630 N Alvernon Way, 1st Fl, Suite 161, Tucson, AZ 85711-1843 | 2013-01-04 |
1023308962 | El Rio Santa Cruz Neighborhood Health Center, Inc | Clinic/Center | 630 N Alvernon Way, Tucson, AZ 85711-1843 | 2011-04-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356959951 | Ridgeline Practice | Counselor | 4625 N Broadway, Suite 105, Tucson, AZ 85711 | 2020-07-20 |
1881229946 | Famiglia Amore II LLC | Assisted Living Facility | 632 N. Wilmot, Tucson, AZ 85711 | 2020-03-10 |
1992343362 | Laurie Anne Mcmahon | Family Medicine | 899 N. Wilmot, Building B, Tucson, AZ 85711 | 2019-12-17 |
1063060093 | Sharese Ann Bailey | Counselor | 300 S Craycroft Rd, Tucson, AZ 85711 | 2019-09-03 |
1467940015 | Jin Zhang | Ophthalmology | 655 N Alvernon Way Ste 204, Tucson, AZ 85711 | 2018-04-30 |
1447779525 | Catherine Butler Hobart | Pharmacist | 535 North Wilmont Road, Suite 101, Tucson, AZ 85711 | 2017-09-11 |
1689196420 | Cope Community Services, Inc. | Case Management | 924 N Alvernon Way, Tucson, AZ 85711 | 2017-07-13 |
1124561477 | Regina Maendler | Behavioral Analyst | 630 N. Craycroft Rd, Tucson, AZ 85711 | 2016-11-18 |
1881140184 | Elleda Linsmeyer | Speech-Language Pathologist | St. Joesph's Hosptial, 350 N. Wilmont Rd., Tucson, AZ 85711 | 2016-08-28 |
1962856260 | Csl-tucson, LLC | Assisted Living Facility | 1020 N. Woodland Avenue, Tucson, AZ 85711 | 2016-04-22 |
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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 |
---|---|---|---|---|
1164031563 | Yun Bunch | Nurse Practitioner | 3220 W Ina Rd Apt 3102, Tucson, AZ 85741-2163 | 2020-07-31 |
1013525534 | James Tutu Fiske I | Nurse Practitioner | 5700 E. Pima Street Suite C., Tucson, AZ 85712 | 2020-07-21 |
1497370258 | Summit Behavioral Health Pllc | Nurse Practitioner | 8230 E Broadway Blvd Ste E7, Tucson, AZ 85710-4002 | 2020-06-08 |
1811523210 | Phillip Allen Stensrud | Nurse Practitioner | 1416 E Linden St, Tucson, AZ 85719-3634 | 2020-03-17 |
1952948911 | Esteem Behavioral Healthcare LLC | Nurse Practitioner | 6650 N Oracle Rd Ste 110, Tucson, AZ 85704-5604 | 2019-12-09 |
1679115489 | Eric James Mccracken | Nurse Practitioner | 1230 South Cherrybell Stravanue, Tucson, AZ 85713 | 2019-10-14 |
1326583014 | Tucson Treatment Center, Inc | Nurse Practitioner | 10573 E Oakbrook St, Tucson, AZ 85747-5966 | 2017-01-04 |
1801266556 | Jennifer Budd | Nurse Practitioner | 2435 N. Castro Avenue, Tucson, AZ 85730 | 2015-10-06 |
1215303946 | Joy Kwakuyi | Nurse Practitioner | 4400 E Broadway Blvd Ste 411, Tucson, AZ 85711-3554 | 2015-08-17 |
1659776557 | Mahmoud Moghaddami | Nurse Practitioner | 1075 E Ft Lowell, Tucson, AZ 85749 | 2014-11-04 |
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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.