| Jennifer Widjaja, | |
|
8035 E Brown Rd, Mesa, AZ 85207-3901 | |
| (623) 295-1190 | |
| Not Available |
| Full Name | Jennifer Widjaja |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Gerontology |
| Location | 8035 E Brown Rd, Mesa, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942008651 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LG0600X | Nurse Practitioner - Gerontology | 317968 (Arizona) | Primary |
| Entity Name | Leading Healthcare Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356853691 PECOS PAC ID: 1850652496 Enrollment ID: O20180222002817 |
| Entity Name | Leading Healthcare Clinic Of Goodyear, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902448566 PECOS PAC ID: 7315377371 Enrollment ID: O20200415002967 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Widjaja, 9458 E Theia Dr, Mesa, AZ 85212-8545 Ph: (480) 240-0555 | Jennifer Widjaja, 8035 E Brown Rd, Mesa, AZ 85207-3901 Ph: (623) 295-1190 |
Aida E Amado, MS, ACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10163 E Jacob Ave, Mesa, AZ 85209 Phone: 480-296-8849 | |
Marilyn Rose Schatz, ACNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6750 E Baywood Ave, Suite 401, Mesa, AZ 85206 Phone: 480-835-7111 Fax: 480-969-9345 | |
Mrs. Krista Ann Roppelt, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3155 E Southern Ave Ste 203, Mesa, AZ 85204 Phone: 480-325-8173 Fax: 480-325-8179 | |
Jennifer Christine Fendler, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 924 N Country Club Dr, Mesa, AZ 85201 Phone: 480-601-3528 | |
Alisha Kristine Holben, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 560 S Bellview, Mesa, AZ 85204 Phone: 276-623-7851 | |
Mari Michelle Hooper, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 646 S Sabrina, Mesa, AZ 85208 Phone: 480-628-8370 | |
Mrs. Marguerite R Galindo, MS, FNP-C, RN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6015 E Brown Rd, Mesa, AZ 85205 Phone: 480-266-4436 |