Individual provider · Type 1 NPI
Irina Khakhanov
Family Nurse Practitioner · Phoenix, AZ
NPI number
1417617002
Active
Practice location
5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Mailing address
15437 N 13th Ave
Phoenix, AZ 85023-4484
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | F11210467 (AZ) |
Family Nurse Practitioner: Definition to come...
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About NPI 1417617002
Irina Khakhanov's National Provider Identifier is 1417617002, issued on Dec 22, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Phoenix, AZ. The record was last updated on Dec 22, 2021.