Provider Demographics
NPI:1891070298
Name:ANAND, MICHELE KMIECIAK (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:KMIECIAK
Last Name:ANAND
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:311 9TH ST N
Mailing Address - Street 2:SUITE 304
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5885
Mailing Address - Country:US
Mailing Address - Phone:239-624-4630
Mailing Address - Fax:239-624-8161
Practice Address - Street 1:311 9TH ST N
Practice Address - Street 2:SUITE 304
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5885
Practice Address - Country:US
Practice Address - Phone:239-624-4630
Practice Address - Fax:239-624-8161
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9174487363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY0K9XOtherBCBS
FLU0452YMedicare PIN