Provider Demographics
NPI:1225224280
Name:RENSHLER-BROWN, ANITA KAYE (PHD, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:KAYE
Last Name:RENSHLER-BROWN
Suffix:
Gender:F
Credentials:PHD, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7418 W LARIAT LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-7357
Mailing Address - Country:US
Mailing Address - Phone:804-231-4641
Mailing Address - Fax:
Practice Address - Street 1:1705 W UNIVERSITY DR STE 104
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-3269
Practice Address - Country:US
Practice Address - Phone:480-493-3444
Practice Address - Fax:480-867-4464
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC264789363L00000X
COC-APN.0001743-C-NP363L00000X
AZAP2643363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ121079Medicare PIN