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General NPI Number Information
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NPI Number | 1194267070
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Entity Type | Individual
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Provider Name | ANZHELA DAVYDOV NP
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Gender | Female
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Dates
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Enumeration Date | 11/09/2016
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 4647 N 32ND ST STE 220
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City | PHOENIX
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State | AZ
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Zip | 85018-3392
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Country | US
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Telephone | 602-907-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 7000 N 16TH ST STE 120-290
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City | PHOENIX
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State | AZ
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Zip | 85020-5512
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Country | US
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Telephone | 480-808-9561
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95005178
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 225621
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License Number State | AZ
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