Provider Demographics
NPI:1942535133
Name:MENTER, ANNA ELIZABETH (PA)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:ELIZABETH
Last Name:MENTER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 41ST AVE
Mailing Address - Street 2:PO BOX 1028
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68602-1028
Mailing Address - Country:US
Mailing Address - Phone:402-563-9224
Mailing Address - Fax:402-564-0611
Practice Address - Street 1:4321 41ST AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-1028
Practice Address - Country:US
Practice Address - Phone:402-563-9224
Practice Address - Fax:402-564-0611
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1468363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant