Provider Demographics
NPI:1659895415
Name:SARTINI, ANISSA HAGEN (CPM)
Entity Type:Individual
Prefix:
First Name:ANISSA
Middle Name:HAGEN
Last Name:SARTINI
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 TRINITY ST
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-5232
Mailing Address - Country:US
Mailing Address - Phone:903-267-4423
Mailing Address - Fax:
Practice Address - Street 1:2504 TRINITY ST
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5232
Practice Address - Country:US
Practice Address - Phone:903-267-4423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
17070016OtherCERTIFIED PROFESSIONAL MIDWIFE