Lie Adi Darmawan, DNP - Registered Nurse in Phoenix, AZ

Lie Adi Darmawan, DNP is a Registered Nurse based in Phoenix, Arizona. Lie Adi Darmawan is licensed to practice in Utah (license number 8519460-3102) and his current practice location is 5777 E Mayo Blvd, Phoenix, Arizona. He can be reached at his office (for appointments etc.) via phone at (480) 342-2000.

NPI number for Lie Adi Darmawan is 1417845819 and his current mailing address is 4301 W Markham St, Education Ii Building, Suite 5104e, Little Rock, Arkansas. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1417845819.

Contact Information

Lie Adi Darmawan, DNP
5777 E Mayo Blvd,
Phoenix, AZ 85054-4502
(480) 342-2000
Not Available

Map and Direction




Provider's Profile

Full NameLie Adi Darmawan
GenderMale
SpecialityRegistered Nurse
Location5777 E Mayo Blvd, Phoenix, Arizona
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1417845819
  • Provider Enumeration Date: 06/25/2025
  • Last Update Date: 06/25/2025

Medical Identifiers

Medical identifiers for Lie Adi Darmawan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417845819NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 8519460-3102 (Utah)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lie Adi Darmawan is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lie Adi Darmawan, DNP
4301 W Markham St, Education Ii Building, Suite 5104e,
Little Rock, AR 72205

Ph: (501) 526-7858
Lie Adi Darmawan, DNP
5777 E Mayo Blvd,
Phoenix, AZ 85054-4502

Ph: (480) 342-2000

Reviews and Comments


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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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