Provider Demographics
NPI:1720588742
Name:NAIR, LAKSHMI (NP PSYCHIATRY)
Entity Type:Individual
Prefix:
First Name:LAKSHMI
Middle Name:
Last Name:NAIR
Suffix:
Gender:F
Credentials:NP PSYCHIATRY
Other - Prefix:
Other - First Name:VIJAYALAKSHMI
Other - Middle Name:
Other - Last Name:MAMMAYIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:14100 N 83RD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4621
Mailing Address - Country:US
Mailing Address - Phone:623-583-0232
Mailing Address - Fax:623-583-1830
Practice Address - Street 1:14100 N 83RD AVE STE 100
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4621
Practice Address - Country:US
Practice Address - Phone:623-583-0232
Practice Address - Fax:623-583-1830
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-16
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY402429363LP0808X
NY681075163W00000X
AZ238344363LP0808X
NY238344363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty