Individual
KASSANDRA NUNEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
926 E MCDOWELL RD STE 134, PHOENIX, AZ 85006-2521
(602) 288-0777
Mailing address
4001 N CENTRAL AVE APT 242, PHOENIX, AZ 85012-2140
(201) 835-8788
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7963
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1175067
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
—
01
—
7963
ARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS
AZ
Enumeration date
03/25/2019
Last updated
11/12/2020
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