Provider Demographics
NPI:1912366840
Name:BINU, ANITHA (NP)
Entity Type:Individual
Prefix:
First Name:ANITHA
Middle Name:
Last Name:BINU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4067 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-7711
Mailing Address - Country:US
Mailing Address - Phone:480-452-3899
Mailing Address - Fax:
Practice Address - Street 1:4067 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-7711
Practice Address - Country:US
Practice Address - Phone:480-452-3899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-20
Last Update Date:2016-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8412363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily