MEDICARE: AICHA EVELYNE KAKOU 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	277245	AZ

General Provider Information

NPI Number	:	1831406222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AICHA EVELYNE KAKOU FNP

Provider Business Mailing Address
First Line	:	234 N CENTRAL AVE # AZ85004
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-2208
Country	:	US
Telephone Number	:	608-481-6389
Fax Number	:

Provider Business Practice Location Address
First Line	:	5650 S 12TH AVE STE 132
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85706-3187
Country	:	US
Telephone Number	:	877-465-6650
Fax Number	:	804-294-2775

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

Provider Enumeration Date	:	09/07/2010
Last Update Date	:	01/30/2026

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