Provider Demographics
NPI:1982655601
Name:REIFF, ANN SIMON (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:SIMON
Last Name:REIFF
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:ANN
Other - Middle Name:SIMON
Other - Last Name:BORRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1343 N ALMA SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5941
Mailing Address - Country:US
Mailing Address - Phone:480-963-1853
Mailing Address - Fax:480-963-1854
Practice Address - Street 1:1343 N ALMA SCHOOL RD
Practice Address - Street 2:STE 160
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5941
Practice Address - Country:US
Practice Address - Phone:480-963-1853
Practice Address - Fax:480-963-1854
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN103430363LF0000X
AZ103430363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00066895OtherRAILROAD
AZ313502Medicaid
AZ844870001Medicaid
AZ313502Medicaid
AZZWDBYT02Medicare PIN
AZP89230Medicare UPIN
AZ844870001Medicaid