Individual
JULIE VELLAKKOTTE YOHANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
483 W SEED FARM RD, SACATON, AZ 85147-5000
(602) 528-1200
(602) 528-1255
Mailing address
PO BOX 38, SACATON, AZ 85147-0001
(602) 528-1200
(602) 528-1255
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP9873
AZ
363LP2300X
Primary Care Nurse Practitioner
AP9873
AZ
Other
Enumeration date
02/08/2017
Last updated
09/10/2021
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