Provider Demographics
NPI:1689095739
Name:GURULE, ANNA (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:GURULE
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 1:520 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELEN
Mailing Address - State:NM
Mailing Address - Zip Code:87002-3720
Mailing Address - Country:US
Mailing Address - Phone:505-966-2002
Mailing Address - Fax:505-966-2050
Practice Address - Street 1:900 ESPERANZA DR
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002-3924
Practice Address - Country:US
Practice Address - Phone:505-966-2002
Practice Address - Fax:505-966-2050
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR25078163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool