Provider Demographics
NPI:1518991512
Name:FIORLETTA, ANITA LOUISE (CRNA)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:LOUISE
Last Name:FIORLETTA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:L
Other - Last Name:HOLLIDAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:10003 BELL ROCK RD
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-9204
Mailing Address - Country:US
Mailing Address - Phone:214-215-9581
Mailing Address - Fax:
Practice Address - Street 1:603 MATLOCK CENTRE CIRCLE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2535
Practice Address - Country:US
Practice Address - Phone:817-701-1161
Practice Address - Fax:817-701-1164
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX219885367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX611931Medicare PIN