MEDICARE: CARA KHAZOYAN FNP

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
1	363LF0000X	Family Nurse Practitioner	120909	CO
2	363LF0000X	Family Nurse Practitioner	389621	CA

General Provider Information

NPI Number	:	1518188010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA KHAZOYAN FNP

Provider Business Mailing Address
First Line	:	9496 PRINCETON CIR
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80130-3728
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3405 DOWNING ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-3972
Country	:	US
Telephone Number	:	303-296-1767
Fax Number	:	303-296-3485

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	07/08/2007

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