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Organization

INNOVATIVE NURSING PRACTICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANNA MANUKYAN NURSE PRACTITIONER (CEO)
(323) 600-5213
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary

Other

Enumeration date
05/17/2021
Last updated
05/17/2021
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