Provider Demographics
NPI:1407296163
Name:BRANSTRATOR, ANNE RENEE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:RENEE
Last Name:BRANSTRATOR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 GOODLETTE RD N STE 101
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4595
Mailing Address - Country:US
Mailing Address - Phone:239-624-8460
Mailing Address - Fax:239-643-1489
Practice Address - Street 1:2450 GOODLETTE RD N STE 101
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4595
Practice Address - Country:US
Practice Address - Phone:239-624-8460
Practice Address - Fax:239-643-1489
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9388494363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY0R08OtherBCBS
FLID412YMedicare PIN