Provider Demographics
NPI:1093058950
Name:VUKANCIC, ANTO N (FNP)
Entity Type:Individual
Prefix:MR
First Name:ANTO
Middle Name:N
Last Name:VUKANCIC
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:25500 N NORTERRA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-8200
Mailing Address - Country:US
Mailing Address - Phone:623-277-1130
Mailing Address - Fax:866-837-6575
Practice Address - Street 1:2302 N 75TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85035-1216
Practice Address - Country:US
Practice Address - Phone:800-233-3264
Practice Address - Fax:623-849-7785
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4837363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner