Provider Demographics
NPI:1407120769
Name:VERDI, AN'A (RN)
Entity Type:Individual
Prefix:
First Name:AN'A
Middle Name:
Last Name:VERDI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1173
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95536-1173
Mailing Address - Country:US
Mailing Address - Phone:707-499-3220
Mailing Address - Fax:
Practice Address - Street 1:3100 EDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-2775
Practice Address - Country:US
Practice Address - Phone:707-499-3220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA811806163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse