Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Licel Tumpap, FNP-C

Individual provider Nurse Practitioner · NPI 1104344969

Mrs. Licel Tumpap, FNP-C is a Nurse Practitioner in Mesa, Arizona. Qualified in 2017, 9 years ago. Practices with Desert Kidney Associates PLC, a 27-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
9
Licensed in
AZ
In the registry since
2017
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

612 W Baseline Rd
Mesa, AZ 85210-6041
Phone: (480) 834-9039
Fax: (480) 964-7802
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence AP10091 (AZ)
Nurse Practitioner Taxonomy 363L00000X · Licence AP10091 (AZ)

Record details

NPI number1104344969
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorYes
NPI enumeratedAugust 31, 2017
Last updated in NPPESOctober 20, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Desert Kidney Associates Plc — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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