KRYSTEN PROVENCIO

GOODYEAR, AZ
NPI1770350761
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: AZ  10672)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2023-12-08
Last Update Date2024-10-09
Business Address
KRYSTEN PROVENCIO
13555 W MCDOWELL RD STE 200
GOODYEAR, AZ 85395-2624
Phone number: 480-756-6000
Mailing Address
KRYSTEN PROVENCIO
2222 S DOBSON RD STE 305
MESA, AZ 85202-6490
Phone number: 480-756-6000