| Provider / Organization | NPI | Date Certified |
|---|---|---|
| IRINA VLADIMIROVNA ASHAMALLA | 1205365772 | 2024-08-12 |
Irina Vladimirovna Ashamalla [F] graduated in 2015 and primarily specializes in Nurse Practitioner.
Irina Vladimirovna Ashamalla is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1205365772. Registration indicates Irina Vladimirovna Ashamalla is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, ) Access to Mental Health/Behavioral Health Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Psych/Mental Health, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Psych/Mental Health, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| PECOS ID | 5698032449 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Mrs. Irina Vladimirovna Ashamalla MSN, FNP-C, PMHNP-BC |
| Practice Office Address | 18001 N 79TH AVE STE B48 GLENDALE, AZ US |
| Practice Office Telephone | 8889068301 |
| Practice Office Fax | 6234046602 |
| Mailing Address | 18001 N 79TH AVE STE B48 GLENDALE, AZ 853088393 US |
| Business Telephone | 8889068301 |
| Business Fax | 6234046602 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 14811 W Bell Rd Ste 102 | Surprise, AZ 853747602 | 6233287323 |
| 10210 W Happy Valley Pkwy Ste 145 | Peoria, AZ 853832881 | 8889068301 / 6234046602 |
| Other URL [] | AthenaHealth | |
| Other URL [] | PracticeFusion |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | AP10066
AZ |
| 363LP0808X PRIMARY | Access to Mental Health/Behavioral Health Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Psych/Mental Health All Other Specialties & Provider Types Nurse Practitioner Psych/Mental Health Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | AP10066
AZ |