Provider Demographics
NPI:1013733393
Name:MANTECON GARCIA, ANNA (NP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MANTECON GARCIA
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 1:4121 W ST NW APT 305
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-4073
Mailing Address - Country:US
Mailing Address - Phone:757-256-5550
Mailing Address - Fax:
Practice Address - Street 1:2000 15TH ST N STE 600
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-2900
Practice Address - Country:US
Practice Address - Phone:703-748-1533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP200003128363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily