Provider Demographics
NPI:1619319696
Name:PANAS, ANNE (RN)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:PANAS
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 1:2149 THOROUGHBRED PKWY
Mailing Address - Street 2:
Mailing Address - City:GOOCHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23063-3248
Mailing Address - Country:US
Mailing Address - Phone:804-314-3480
Mailing Address - Fax:
Practice Address - Street 1:2149 THOROUGHBRED PKWY
Practice Address - Street 2:
Practice Address - City:GOOCHLAND
Practice Address - State:VA
Practice Address - Zip Code:23063-3248
Practice Address - Country:US
Practice Address - Phone:804-314-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001239534163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse