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NPI Code Detail

MEDICARE: MRS. SIJI OMMEN ARNP

MEDICARE:  MRS. SIJI  OMMEN  ARNP
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
1163WG0000XGeneral Practice Registered NurseARNP 9243268FL

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 : 1528414638
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SIJI OMMEN ARNP
Provider Business Mailing Address
First Line : 18600 SW 16TH ST
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33029-6132
Country : US
Telephone Number : 786-382-1218
Fax Number :
Provider Business Practice Location Address
First Line : 18600 SW 16TH ST
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33029-6132
Country : US
Telephone Number : 786-382-1218
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2016
Last Update Date : 05/06/2016

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