Lydic, Joni Suzanne

Lydic, Joni Suzanne is an individual health care provider with primary practice located at 2302 N 75Th Ave , Phoenix AZ 85035-1216. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Lydic, Joni Suzanne can be contacted via phone (623) 849-7500.

Contact Information

Primary practice address
2302 N 75Th Ave Phoenix AZ 85035-1216
Phone: (623) 849-7500
Fax: (623) 849-7588
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN041417 Arizona

Profile Details

NPI number 1518964782
LBN Legal business name Lydic, Joni Suzanne
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2005
Last updated Feb 29th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518964782 NPPES
Arizona MEDICAID 481416

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