Provider Demographics
NPI:1588178123
Name:ZUNIGA, ANNA MARCELA (LPN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARCELA
Last Name:ZUNIGA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 LONE STAR LN
Mailing Address - Street 2:
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85621-9019
Mailing Address - Country:US
Mailing Address - Phone:520-980-6914
Mailing Address - Fax:
Practice Address - Street 1:131 CAMINO MARICOPA
Practice Address - Street 2:
Practice Address - City:RIO RICO
Practice Address - State:AZ
Practice Address - Zip Code:85648-1817
Practice Address - Country:US
Practice Address - Phone:520-375-8669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP036315164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse