Provider Demographics
NPI:1821497983
Name:GARCIA, ANITA (RN)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:GARCIA
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 1:1041 S. 14TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAFFORD
Mailing Address - State:AZ
Mailing Address - Zip Code:85546-3738
Mailing Address - Country:US
Mailing Address - Phone:928-348-7030
Mailing Address - Fax:
Practice Address - Street 1:1041 S 14TH AVE
Practice Address - Street 2:
Practice Address - City:SAFFORD
Practice Address - State:AZ
Practice Address - Zip Code:85546-3459
Practice Address - Country:US
Practice Address - Phone:928-348-7030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN173868163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool