Provider Demographics
NPI:1205699543
Name:FARRAKHAN, ANNE (PRSS)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:FARRAKHAN
Suffix:
Gender:F
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14362 N FRANK LLOYD WRIGHT BLVD STE B111
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-8881
Mailing Address - Country:US
Mailing Address - Phone:480-912-3105
Mailing Address - Fax:480-912-3106
Practice Address - Street 1:14362 N FRANK LLOYD WRIGHT BLVD STE B111
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-8881
Practice Address - Country:US
Practice Address - Phone:480-912-3105
Practice Address - Fax:480-912-3106
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist