Provider Demographics
NPI:1245753730
Name:GANTZ, ANNETTE JO (FNP)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:JO
Last Name:GANTZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:JO
Other - Last Name:KERR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:9150 HUEBNER RD STE 290
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1598
Mailing Address - Country:US
Mailing Address - Phone:210-614-6432
Mailing Address - Fax:210-293-2989
Practice Address - Street 1:18626 HARDY OAK BLVD STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4228
Practice Address - Country:US
Practice Address - Phone:210-495-9047
Practice Address - Fax:210-293-2989
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134256363L00000X, 363LF0000X
OHCNP.020968363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner