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NPI Code Detail

MEDICARE: SOBHA KRISHNAKUMAR MSN FNP-C

MEDICARE: SOBHA KRISHNAKUMAR MSN 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
1363LP2300XPrimary Care Nurse PractitionerAP8021AZ

General Provider Information

NPI Number : 1578939898
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOBHA KRISHNAKUMAR MSN FNP-C
Provider Business Mailing Address
First Line : 2702 NORTH 3RD STREET
Second Line : SUITE 4020
City : PHOENIX
State : AZ
Zip : 85004-4608
Country : US
Telephone Number : 602-243-7277
Fax Number : 602-323-3399
Provider Business Practice Location Address
First Line : 3830 E VAN BUREN ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-6920
Country : US
Telephone Number : 602-243-7277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2015
Last Update Date : 08/27/2015

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Directions to “ SOBHA KRISHNAKUMAR MSN FNP-C” Practice Location

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