Provider Demographics
NPI:1275696288
Name:KAY, LINA (PA-C)
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:
Last Name:KAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINA
Other - Middle Name:
Other - Last Name:GULKAROVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:10181 N 92ND ST
Mailing Address - Street 2:STE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4559
Mailing Address - Country:US
Mailing Address - Phone:480-502-1158
Mailing Address - Fax:
Practice Address - Street 1:4545 E CHANDLER BLVD STE 206
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-7645
Practice Address - Country:US
Practice Address - Phone:480-961-5956
Practice Address - Fax:480-598-1314
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2733363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical