Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KRYSTEN PROVENCIO
ActiveKRYSTEN PROVENCIO is a Physician Assistant healthcare provider located in GOODYEAR, Arizona. NPI 1770350761 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · GOODYEAR, AZ
Registration Details
- NPI Number
- 1770350761
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 8, 2023 (2.6776817460841 yrs)
- Last Updated
- Oct 9, 2024
- License
-
10672 (AZ)
Practice Information
- Address
-
13555 W MCDOWELL RD STE 200GOODYEAR, AZ, 853952624Browse AZ providers · Browse ZIP 85395
- Phone
- 4807566000
- Fax
- 8556368770
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in GOODYEAR, AZ
| Name | Credential | NPI |
|---|---|---|
| KEITH D WINTERS | PA-C | 1558334243 |
| MRS. REINA MARIA OCASIO | PA-C | 1932177748 |
| SHANNON M. HOGAN | PA-C | 1801865845 |
| MRS. LORI LYNNE HARDACKER | PA | 1780612952 |
| DIANA HOULE | P.A. | 1992815450 |
| MRS. KELLI ANN MERCADO | PA | 1255426870 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.