Mary Lucille Jansma, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP30005737 Issued in WA

Practice address

600 N. Broadway
Longview, WA 98632-0302

Phone

(360) 414-2177

Fax

(360) 414-2210

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1811060874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3002",
            "address_2": "600 N. BROADWAY",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986320302",
            "telephone_number": "360-414-2177",
            "fax_number": "360-414-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N. BROADWAY",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986320302",
            "telephone_number": "360-414-2177",
            "fax_number": "360-414-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSMA",
        "first_name": "MARY",
        "middle_name": "LUCILLE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30005737",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30005737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9652611",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8944406",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & IND.",
            "identifier": "0220991",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sanjeev Jain, M.D.; PHD
• Miranda Jaksha, SUDP-T
• James L Boylon MD PS
• Rochalle Irene James
• Maureen Jamieson, CRNA
• Jared a Franson, DMD, PS
• Melissa Jarvis
• JD Troy DDS PLLC
• Aniezka M Jenissen, LMHC, CDP
• Danielle L Jenkins Thompson, MA

• Nurse Practitioner in Longview, WA
• Providers in Longview, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.