Provider Demographics
NPI:1073893335
Name:VELASCO-NEAVES, ANNA M (MSN, APN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:VELASCO-NEAVES
Suffix:
Gender:F
Credentials:MSN, APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16403 HUEBNER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1683
Mailing Address - Country:US
Mailing Address - Phone:210-493-4357
Mailing Address - Fax:210-493-4355
Practice Address - Street 1:16403 HUEBNER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-1683
Practice Address - Country:US
Practice Address - Phone:210-493-4357
Practice Address - Fax:210-493-4355
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP120757363LF0000X
TX642204363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX329329202Medicaid
TX329329203OtherCSHCN