Provider Demographics
NPI:1700373735
Name:STINNEY, ANITRA (RN, BS)
Entity Type:Individual
Prefix:
First Name:ANITRA
Middle Name:
Last Name:STINNEY
Suffix:
Gender:F
Credentials:RN, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 ASPEN CIR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1302
Mailing Address - Country:US
Mailing Address - Phone:518-992-0026
Mailing Address - Fax:
Practice Address - Street 1:31 ASPEN CIR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1302
Practice Address - Country:US
Practice Address - Phone:518-992-0026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY625989163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse