Provider Demographics
NPI:1205319951
Name:SAIZ, ANNALISA (BSN)
Entity type:Individual
Prefix:MS
First Name:ANNALISA
Middle Name:
Last Name:SAIZ
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:MS
Other - First Name:ANNALISA
Other - Middle Name:
Other - Last Name:HINOJOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN
Mailing Address - Street 1:3175 E GORDON DR
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3303
Mailing Address - Country:US
Mailing Address - Phone:928-753-6412
Mailing Address - Fax:928-753-6413
Practice Address - Street 1:3175 E GORDON DR
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-3303
Practice Address - Country:US
Practice Address - Phone:928-753-6412
Practice Address - Fax:928-753-6413
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN735508163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN735508OtherREGISTERED NURSE