Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Irina Khakhanov

Individual provider Family Nurse Practitioner · NPI 1417617002

Irina Khakhanov is a Family Nurse Practitioner in Phoenix, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2021

Practice location Address checks out

5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone: (646) 249-5910
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence F11210467 (AZ)

Record details

NPI number1417617002
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 22, 2021
Last updated in NPPESDecember 22, 2021
Certification dateDecember 22, 2021

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