KRYSTEN PROVENCIO
Physician Assistant
Active
Individual
NPI: 1770350761
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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