Individual
SHEEBA KALAPPURAKKAL DIVAKARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3601 N 6TH AVE APT A8, PHOENIX, AZ 85013-3738
(602) 653-3075
Mailing address
3601 N 6TH AVE APT A8, PHOENIX, AZ 85013-3738
(602) 653-3075
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
141069
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
255711
AZ
Other
Enumeration date
10/08/2020
Last updated
03/31/2021
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