Provider Demographics
NPI:1972375459
Name:LIM, MAJU (FNP C)
Entity type:Individual
Prefix:
First Name:MAJU
Middle Name:
Last Name:LIM
Suffix:
Gender:M
Credentials:FNP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4389 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8474
Mailing Address - Country:US
Mailing Address - Phone:928-581-2669
Mailing Address - Fax:
Practice Address - Street 1:675 S AVENUE B BLDG A
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-2749
Practice Address - Country:US
Practice Address - Phone:928-539-3140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ299017363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily