Provider Demographics
NPI:1215214325
Name:ANISI, CHRISTIANA CHIMA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIANA
Middle Name:CHIMA
Last Name:ANISI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:14297 ANACAPA CT
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-3786
Mailing Address - Country:US
Mailing Address - Phone:909-829-0802
Mailing Address - Fax:909-464-0523
Practice Address - Street 1:2112 S. GAREY AVE
Practice Address - Street 2:SUITE C
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-5600
Practice Address - Country:US
Practice Address - Phone:909-464-0520
Practice Address - Fax:909-464-0523
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20398363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner