Individual provider · Type 1 NPI
Ajie Jibu Mammarappallil, AGACNP
Acute Care Nurse Practitioner · Palos Heights, IL
NPI number
1215510987
Active
Practice location
12251 S 80th Ave
Palos Heights, IL 60463-1290
Mailing address
17704 Radcliffe Ct
Tinley Park, IL 60487-2291
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner Primary | 363LA2100X | 209022913 (IL) |
| Gerontology Nurse Practitioner | 363LG0600X | 209022913 (IL) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1215510987
Ajie Jibu Mammarappallil, AGACNP's National Provider Identifier is 1215510987, issued on Apr 30, 2021. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Palos Heights, IL. The record was last updated on Apr 30, 2021.