Provider Demographics
NPI:1568016368
Name:SAMONS, ANNA MARIE (NP-C)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:SAMONS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2585 SAN JUAN DR
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-3151
Mailing Address - Country:US
Mailing Address - Phone:928-727-1986
Mailing Address - Fax:
Practice Address - Street 1:2585 SAN JUAN DR
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-3151
Practice Address - Country:US
Practice Address - Phone:928-727-1986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRNP230161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily