MEDICARE: MASHA GRIGORIEVNA MARKOSYAN MSN-FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95033919	CA

General Provider Information

NPI Number	:	1356284814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MASHA GRIGORIEVNA MARKOSYAN MSN-FNP

Provider Business Mailing Address
First Line	:	11840 W TUDOR CT
Second Line	:
City	:	PORTER RANCH
State	:	CA
Zip	:	91326-4985
Country	:	US
Telephone Number	:	818-641-8786
Fax Number	:

Provider Business Practice Location Address
First Line	:	11840 W TUDOR CT
Second Line	:
City	:	PORTER RANCH
State	:	CA
Zip	:	91326-4985
Country	:	US
Telephone Number	:	818-641-8786
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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