Provider Demographics
NPI:1467702555
Name:STIVER, ANITA KAE (STNA)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:KAE
Last Name:STIVER
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 PHILLIPSBURG UNION RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45322-9750
Mailing Address - Country:US
Mailing Address - Phone:937-836-6411
Mailing Address - Fax:
Practice Address - Street 1:115 PHILLIPSBURG UNION RD
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:OH
Practice Address - Zip Code:45322-9750
Practice Address - Country:US
Practice Address - Phone:937-836-6411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-15
Last Update Date:2012-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401025540110376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide