KRYSTEN PROVENCIO

Physician Assistant

Active Individual
NPI: 1770350761

Practice Address

13555 W MCDOWELL RD STE 200
Goodyear, AZ 85395

Phone: (480) 756-6000

Specialties

Specialty Code Primary License
Student in an Organized Health Care Education/Training Program 390200000X No -
Physician Assistant 363A00000X Yes 10672 (AZ)

Frequently Asked Questions

NPI 1770350761 is the National Provider Identifier for KRYSTEN PROVENCIO, a Physician Assistant provider located in Goodyear, AZ. This NPI was enumerated on December 8, 2023.
KRYSTEN PROVENCIO practices at 13555 W MCDOWELL RD STE 200, Goodyear, AZ 85395.

Quick Facts

NPI
1770350761
Type
Individual
Enumerated
Dec 8, 2023
Last Updated
Oct 9, 2024

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