Provider Demographics
NPI:1144230889
Name:MCNANLEY, ANNA R (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:R
Last Name:MCNANLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3931 LOUISIANA AVE S
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-4375
Mailing Address - Country:US
Mailing Address - Phone:952-993-1586
Mailing Address - Fax:952-993-3213
Practice Address - Street 1:3931 LOUISIANA AVE S
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-4375
Practice Address - Country:US
Practice Address - Phone:952-993-1586
Practice Address - Fax:952-993-3213
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN52687207VF0040X, 207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02777420Medicaid
NY187468CKOtherPREFERRED CARE
MNP00866685OtherRAILROAD MEDICARE
NYRB4080Medicare PIN