Provider Demographics
NPI:1164723300
Name:ELKIN, JANINA MARIE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JANINA
Middle Name:MARIE
Last Name:ELKIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JANINA
Other - Middle Name:MARIE
Other - Last Name:GRUBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX PH
Mailing Address - Street 2:
Mailing Address - City:CHINLE
Mailing Address - State:AZ
Mailing Address - Zip Code:86503-8000
Mailing Address - Country:US
Mailing Address - Phone:928-674-7001
Mailing Address - Fax:928-674-7008
Practice Address - Street 1:105 S DELAWARE DR STE 1
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-6512
Practice Address - Country:US
Practice Address - Phone:480-646-1001
Practice Address - Fax:480-646-1002
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP3832OtherARIZONA STATE BOARD OF NURSING