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NPI Code Detail

MEDICARE: SUSAN MARIE JABLONSKI FNP-C, PMHNP-BC

MEDICARE: SUSAN MARIE JABLONSKI FNP-C, PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAP10281AZ
2363LP0808XPsychiatric/Mental Health Nurse Practitioner78919ID
3363LP0808XPsychiatric/Mental Health Nurse PractitionerCP003124SD
4363LP0808XPsychiatric/Mental Health Nurse Practitioner227670AR
5363LP0808XPsychiatric/Mental Health Nurse PractitionerAP115768TX
6363LP0808XPsychiatric/Mental Health Nurse Practitioner53781WY
7363LP0808XPsychiatric/Mental Health Nurse Practitioner207061OK
8363LP0808XPsychiatric/Mental Health Nurse Practitioner10022479OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770659369
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN MARIE JABLONSKI FNP-C, PMHNP-BC
Provider Business Mailing Address
First Line : 3409 N 7TH AVE STE C109
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-3635
Country : US
Telephone Number : 602-883-2917
Fax Number : 602-753-9763
Provider Business Practice Location Address
First Line : 3409 N 7TH AVE STE C109
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-3635
Country : US
Telephone Number : 602-883-2917
Fax Number : 602-753-9763
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2006
Last Update Date : 04/22/2025

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