Provider Demographics
NPI:1255150686
Name:NAGY, ANAISA (FNP-BC)
Entity type:Individual
Prefix:
First Name:ANAISA
Middle Name:
Last Name:NAGY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1656 N BOSWORTH AVE APT 3S
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-8065
Mailing Address - Country:US
Mailing Address - Phone:920-257-7865
Mailing Address - Fax:
Practice Address - Street 1:1656 N BOSWORTH AVE APT 3S
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-8065
Practice Address - Country:US
Practice Address - Phone:920-257-7865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209027791363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner