Provider Demographics
NPI:1871032474
Name:KAMINENI, KRISHNA PALLAVI (MD)
Entity Type:Individual
Prefix:
First Name:KRISHNA
Middle Name:PALLAVI
Last Name:KAMINENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 W ELLIOT RD
Mailing Address - Street 2:APT :3097
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-1150
Mailing Address - Country:US
Mailing Address - Phone:210-952-0099
Mailing Address - Fax:
Practice Address - Street 1:1155 W ELLIOT RD
Practice Address - Street 2:APT 3097
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1150
Practice Address - Country:US
Practice Address - Phone:210-952-0099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program