# KAVITHA KRISHNAMANI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1629196282
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 59825 | AZ | Yes |
| 207Q00000X | Family Medicine Physician | MD00047733 | WA | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | ML20008124 | WA | — |

## Other

- **Enumeration date:** 03/26/2007
- **Last updated:** 11/06/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 149726 | — | AZ |