Provider Demographics
NPI:1861730988
Name:ABUCHA, JANE MESIKU (DNP, ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:MESIKU
Last Name:ABUCHA
Suffix:
Gender:F
Credentials:DNP, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12851 W BELL RD STE 126
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85378-9610
Mailing Address - Country:US
Mailing Address - Phone:623-399-9645
Mailing Address - Fax:866-355-0977
Practice Address - Street 1:12851 W BELL RD STE 126
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-9610
Practice Address - Country:US
Practice Address - Phone:623-399-9645
Practice Address - Fax:866-355-0977
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4804363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ796987Medicaid