Provider Demographics
NPI:1073236360
Name:ARZUMANOVA, ANETA (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANETA
Middle Name:
Last Name:ARZUMANOVA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24981
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2000
Mailing Address - Country:US
Mailing Address - Phone:844-969-0686
Mailing Address - Fax:773-832-7083
Practice Address - Street 1:5421 W THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4751
Practice Address - Country:US
Practice Address - Phone:602-755-0800
Practice Address - Fax:602-560-2721
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ283384363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty