Provider Demographics
NPI:1346713617
Name:PRINGLE, ANTHONY (NP)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:PRINGLE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 LAIDLEY ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-2767
Mailing Address - Country:US
Mailing Address - Phone:415-439-9179
Mailing Address - Fax:
Practice Address - Street 1:1545 DIVISADERO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-3400
Practice Address - Country:US
Practice Address - Phone:415-353-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010194363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95010194OtherCALIFORNIA BOARD OF REGISTERED NURSING NUMBER