Provider Demographics
NPI:1629605506
Name:NUNEZ NUNEZ, ANA YELY (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:YELY
Last Name:NUNEZ NUNEZ
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6017 MIRAMONTE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90001-1327
Mailing Address - Country:US
Mailing Address - Phone:323-362-3563
Mailing Address - Fax:
Practice Address - Street 1:6017 MIRAMONTE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90001-1327
Practice Address - Country:US
Practice Address - Phone:323-362-3563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014256363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily