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

TaxonomyCodeLicense
Acute Care Nurse Practitioner Primary 363LA2100X209022913 (IL)
Gerontology Nurse Practitioner 363LG0600X209022913 (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.