Provider Demographics
NPI:1275030249
Name:ARTACHE, ANNETTE (DNAP)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:ARTACHE
Suffix:
Gender:F
Credentials:DNAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 46TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-3203
Mailing Address - Country:US
Mailing Address - Phone:928-273-8401
Mailing Address - Fax:928-273-8401
Practice Address - Street 1:871 46TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-3203
Practice Address - Country:US
Practice Address - Phone:928-273-8401
Practice Address - Fax:928-273-8401
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA772637367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered