Provider Demographics
NPI:1245075126
Name:MARKOSYAN, SYUZANNA (FNP)
Entity type:Individual
Prefix:
First Name:SYUZANNA
Middle Name:
Last Name:MARKOSYAN
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 1:325 N FIRST ST APT 210
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1887
Mailing Address - Country:US
Mailing Address - Phone:323-229-4217
Mailing Address - Fax:
Practice Address - Street 1:8027 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SUNLAND
Practice Address - State:CA
Practice Address - Zip Code:91040-2957
Practice Address - Country:US
Practice Address - Phone:747-342-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023952363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily