Provider Demographics
NPI:1164723300
Name:ELKIN, JANINA MARIE (FNP)
Entity type:Individual
Prefix:MRS
First Name:JANINA
Middle Name:MARIE
Last Name:ELKIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JANINA
Other - Middle Name:MARIE
Other - Last Name:GRUBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:261 N ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2617
Mailing Address - Country:US
Mailing Address - Phone:480-677-8282
Mailing Address - Fax:844-470-2777
Practice Address - Street 1:3546 S. POWER RD. #101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234
Practice Address - Country:US
Practice Address - Phone:480-677-8282
Practice Address - Fax:844-470-2777
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ583341Medicaid