Provider Demographics
NPI:1518392471
Name:JOHN, ANILA (RN,FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANILA
Middle Name:
Last Name:JOHN
Suffix:
Gender:F
Credentials:RN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 NORWOOD RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-1416
Mailing Address - Country:US
Mailing Address - Phone:914-793-6191
Mailing Address - Fax:
Practice Address - Street 1:90 NORWOOD RD
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-1416
Practice Address - Country:US
Practice Address - Phone:914-793-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337811363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily