Provider Demographics
NPI:1710003355
Name:ANTHONY, ANDREW B (DC, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:B
Last Name:ANTHONY
Suffix:
Gender:M
Credentials:DC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 W UNION HILLS DR STE B1500
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1062
Mailing Address - Country:US
Mailing Address - Phone:623-776-6633
Mailing Address - Fax:
Practice Address - Street 1:6320 W UNION HILLS DR STE B1500
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1062
Practice Address - Country:US
Practice Address - Phone:480-625-4599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ246065363LF0000X
AZ7556111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor