# INNOVATIVE NURSING PRACTICE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346814225
- **Authorized official:** ANNA MANUKYAN NURSE PRACTITIONER (CEO)
- **Authorized official phone:** (323) 600-5213

## Contact information

- **Practice address:** 1241 S GLENDALE AVE STE 201, GLENDALE, CA 91205-3388
- **Practice address phone:** (323) 600-5213
- **Mailing address:** 1935 ALPHA RD UNIT 232, GLENDALE, CA 91208-2139
- **Mailing address phone:** (323) 600-5213

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/17/2021
- **Last updated:** 05/17/2021