Individual provider · Type 1 NPI
McKenzi Farak
Surgical Physician Assistant · Phoenix, AZ
NPI number
1740178417
Active
Practice location
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Mailing address
5853 E Jasmine St
Mesa, AZ 85205-3509
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | None listed |
| Surgical Physician Assistant Primary | 363AS0400X | 11146 (AZ) |
Surgical Physician Assistant: Definition to come...
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About NPI 1740178417
McKenzi Farak's National Provider Identifier is 1740178417, issued on Jun 24, 2025. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Phoenix, AZ. The record was last updated on Aug 14, 2025.