Provider Demographics
NPI:1366643843
Name:DRAZENOVIC, ANNA MARIE (FNP)
Entity Type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:MARIE
Last Name:DRAZENOVIC
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12051 S 44TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-2435
Mailing Address - Country:US
Mailing Address - Phone:480-496-6407
Mailing Address - Fax:
Practice Address - Street 1:12051 S 44TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-2435
Practice Address - Country:US
Practice Address - Phone:480-496-6407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily