| Jesse Headapohl Fatoma, | |
|
11770 W Davis Ln, Avondale, AZ 85323-7695 | |
| (480) 217-8964 | |
| Not Available |
| Full Name | Jesse Headapohl Fatoma |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 1 Years |
| Location | 11770 W Davis Ln, Avondale, Arizona |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407743891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 326908 (Arizona) | Primary |
| 163WP0808X | Registered Nurse - Psychiatric/mental Health | RN204116 (Arizona) | Secondary |
| Entity Name | Connectionsaz LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083840953 PECOS PAC ID: 3072858745 Enrollment ID: O20181227002230 |
| Mailing Address | Practice Location Address |
|---|---|
| Jesse Headapohl Fatoma, 11770 W Davis Ln, Avondale, AZ 85323-7695 Ph: (480) 217-8964 | Jesse Headapohl Fatoma, 11770 W Davis Ln, Avondale, AZ 85323-7695 Ph: (480) 217-8964 |
Mr. Justin Markel Belford, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3426 N 126th Dr, Avondale, AZ 85392 Phone: 623-695-4011 |
Kathleen Marie Decker, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 824 N 99th Ave Ste 109, Avondale, AZ 85323 Phone: 623-907-1457 |
Courtney Standifird, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10450 W Mcdowell Rd Ste 101, Avondale, AZ 85392 Phone: 623-935-1000 |
Lauren Scarponi, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 11435 W Buckeye Rd Ste A106, Avondale, AZ 85323 Phone: 480-677-8282 Fax: 888-316-1686 |
Mrs. Ijeoma J Igbokwe, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 12387 W Glenrosa Ave, Avondale, AZ 85392 Phone: 623-810-0515 |
Kia Lambeth, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10815 W Mcdowell Rd Ste 305, Avondale, AZ 85392 Phone: 623-936-3312 Fax: 623-936-4248 |
Amy Christine Amore, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13075 W Mcdowell Rd Ste D106, Avondale, AZ 85392 Phone: 623-547-0522 |