Provider Demographics
NPI:1518445774
Name:ANZALDUA, YOLANDA (RN)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:ANZALDUA
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 1:2705 E MARK CIR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-3302
Mailing Address - Country:US
Mailing Address - Phone:956-730-8589
Mailing Address - Fax:
Practice Address - Street 1:2705 E MARK CIR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-3302
Practice Address - Country:US
Practice Address - Phone:956-730-8589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX548726163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1790847531Medicaid