Provider Demographics
NPI:1336652478
Name:KILANO, RULA MICHELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:RULA
Middle Name:MICHELLE
Last Name:KILANO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 S ALMA SCHOOL RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-8120
Mailing Address - Country:US
Mailing Address - Phone:480-827-5014
Mailing Address - Fax:
Practice Address - Street 1:2950 S ALMA SCHOOL RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-8120
Practice Address - Country:US
Practice Address - Phone:480-827-5014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-12
Last Update Date:2017-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6836363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical