Healthcare Provider Details

I. General information

NPI: 1508015777
Provider Name (Legal Business Name): TIGE ADAM BJORNSON CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2008
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 E CAMELBACK RD STE 200
PHOENIX AZ
85016-3913
US

IV. Provider business mailing address

1661 E CAMELBACK RD STE 200
PHOENIX AZ
85016-3913
US

V. Phone/Fax

Practice location:
  • Phone: 602-231-3686
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number301246
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: