Healthcare Provider Details

I. General information

NPI: 1841627247
Provider Name (Legal Business Name): ANNA ALEXANDRA MKRTCHYAN NMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 11/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6115 S KYRENE RD SUITE #201
TEMPE AZ
85283-1723
US

IV. Provider business mailing address

6115 S KYRENE RD SUITE #201
TEMPE AZ
85283-1723
US

V. Phone/Fax

Practice location:
  • Phone: 480-543-1116
  • Fax: 480-543-1118
Mailing address:
  • Phone: 480-543-1116
  • Fax: 480-543-1118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number13-1389
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: