Provider Demographics
NPI:1770822546
Name:CAVIN, ANNA MARIA (RN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:CAVIN
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 1:4888 LOCHERBY DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-4383
Mailing Address - Country:US
Mailing Address - Phone:678-577-4452
Mailing Address - Fax:
Practice Address - Street 1:4888 LOCHERBY DR
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-4383
Practice Address - Country:US
Practice Address - Phone:678-577-4452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-13
Last Update Date:2013-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN189579163WC1500X
GARN189579163WH1000X, 163WP0808X, 163WG0000X, 163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WG0600XNursing Service ProvidersRegistered NurseGerontology