Provider Demographics
NPI:1952395386
Name:BERNACCHI, ALANNA CRISTIN (DC)
Entity Type:Individual
Prefix:
First Name:ALANNA
Middle Name:CRISTIN
Last Name:BERNACCHI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ALANNA
Other - Middle Name:CRISTIN
Other - Last Name:GREIB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:9812 N. 7TH ST
Mailing Address - Street 2:#6
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020
Mailing Address - Country:US
Mailing Address - Phone:602-870-1876
Mailing Address - Fax:602-997-2291
Practice Address - Street 1:9812 N. 7TH ST
Practice Address - Street 2:#6
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020
Practice Address - Country:US
Practice Address - Phone:602-870-1876
Practice Address - Fax:602-997-2291
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ7286111N00000X
AZ7286AZ111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ72743Medicare PIN
AZU93839Medicare UPIN