Provider Demographics
NPI:1407392806
Name:LAIMO, LILIAN LIMBI (FNP-BC)
Entity type:Individual
Prefix:
First Name:LILIAN
Middle Name:LIMBI
Last Name:LAIMO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 S MILL AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-6850
Mailing Address - Country:US
Mailing Address - Phone:480-305-2888
Mailing Address - Fax:480-305-2889
Practice Address - Street 1:855 E BROWN RD STE 10
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-4949
Practice Address - Country:US
Practice Address - Phone:623-910-3171
Practice Address - Fax:480-305-2889
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN165287163W00000X
AZAP9783363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ008520Medicaid