Provider Demographics
NPI:1346353364
Name:SALL, ANNA W (FNP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:W
Last Name:SALL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:WEISMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17032 NORTHWAY CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-5905
Mailing Address - Country:US
Mailing Address - Phone:415-827-6672
Mailing Address - Fax:
Practice Address - Street 1:2950 CLEVELAND CLINIC BLVD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3609
Practice Address - Country:US
Practice Address - Phone:954-659-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16372363LF0000X
FLARNP9336673363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily