MEDICARE: JAIME LECOMTE PMHNP-BC, FNP-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
1	363LF0000X	Family Nurse Practitioner	324973	AZ
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	324973	AZ
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	C-APN.0104569-C-NP	CO
4	363LF0000X	Family Nurse Practitioner	C-APN.0104569-C-NP	CO

General Provider Information

NPI Number	:	1740858778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIME LECOMTE PMHNP-BC, FNP-BC

Provider Business Mailing Address
First Line	:	845 W CAMPBELL AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-2612
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	845 W CAMPBELL AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-2612
Country	:	US
Telephone Number	:	602-834-6588
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2021
Last Update Date	:	12/12/2025

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