Provider Demographics
NPI:1760240626
Name:MKHITARYAN, NAIRA (FNP)
Entity Type:Individual
Prefix:MISS
First Name:NAIRA
Middle Name:
Last Name:MKHITARYAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 N ALEXANDRIA AVE # 1/4
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-4003
Mailing Address - Country:US
Mailing Address - Phone:323-580-8018
Mailing Address - Fax:
Practice Address - Street 1:1824 N ALEXANDRIA AVE # 1/4
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-4003
Practice Address - Country:US
Practice Address - Phone:323-580-8018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029308363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily