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NPI Code Detail

MEDICARE: MARYANN GEVSHANYAN MSN, APRN, FNP-C

MEDICARE: MARYANN GEVSHANYAN MSN, APRN, FNP-C
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
1363LF0000XFamily Nurse Practitioner95027713CA

General Provider Information

NPI Number : 1528840212
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYANN GEVSHANYAN MSN, APRN, FNP-C
Provider Business Mailing Address
First Line : 1071 E ANGELENO AVE
Second Line :
City : BURBANK
State : CA
Zip : 91501-1420
Country : US
Telephone Number : 818-720-8884
Fax Number : 818-478-1827
Provider Business Practice Location Address
First Line : 4318 W VICTORY BLVD
Second Line :
City : BURBANK
State : CA
Zip : 91505-1334
Country : US
Telephone Number : 818-275-7554
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2023
Last Update Date : 04/09/2026

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