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General NPI Number Information
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NPI Number | 1528840212
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Entity Type | Individual
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Provider Name | MARYANN GEVSHANYAN MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/17/2023
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 303 N GLENOAKS BLVD # 233
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City | BURBANK
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State | CA
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Zip | 91502-1116
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Country | US
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Telephone | 818-748-3042
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Fax | 818-748-3043
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Provider Business Mailing Address
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Address Line | 1071 E ANGELENO AVE
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City | BURBANK
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State | CA
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Zip | 91501-1420
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Country | US
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Telephone | 818-720-8884
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Fax | 818-478-1827
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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 | 95027713
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License Number State | CA
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