Provider Demographics
NPI:1679295612
Name:OAK, ANYA (RN, CNP)
Entity Type:Individual
Prefix:
First Name:ANYA
Middle Name:
Last Name:OAK
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29663 295TH LN
Mailing Address - Street 2:
Mailing Address - City:LINDSTROM
Mailing Address - State:MN
Mailing Address - Zip Code:55045-8077
Mailing Address - Country:US
Mailing Address - Phone:218-849-6401
Mailing Address - Fax:
Practice Address - Street 1:671 VANDALIA ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1312
Practice Address - Country:US
Practice Address - Phone:651-696-5674
Practice Address - Fax:651-698-2405
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9492363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health