Provider Demographics
NPI:1275670333
Name:SQUIRES, ANNE PATTERSON (CFNP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:PATTERSON
Last Name:SQUIRES
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 7TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-6023
Mailing Address - Country:US
Mailing Address - Phone:202-543-6017
Mailing Address - Fax:202-547-1871
Practice Address - Street 1:1220 12TH ST SE
Practice Address - Street 2:SUITE 120
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3722
Practice Address - Country:US
Practice Address - Phone:202-546-0936
Practice Address - Fax:202-547-1871
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN967955363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC024905300Medicaid
DC241543Medicaid
DC4926Medicaid