Individual
KRISTINA KOAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
19000 N 63RD AVE, GLENDALE, AZ 85308-7138
(623) 376-4310
Mailing address
20402 N 15TH AVE, PHOENIX, AZ 85027-3699
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN157750
AZ
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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