Provider Demographics
NPI:1396935938
Name:STENNETT-ANDERSON, PRUDENCE IONA (FNPC)
Entity type:Individual
Prefix:MRS
First Name:PRUDENCE
Middle Name:IONA
Last Name:STENNETT-ANDERSON
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1543 E PALMDALE BLVD
Mailing Address - Street 2:STE C
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-2000
Mailing Address - Country:US
Mailing Address - Phone:661-274-1200
Mailing Address - Fax:661-274-1199
Practice Address - Street 1:1543 E PALMDALE BLVD
Practice Address - Street 2:STE C
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-2000
Practice Address - Country:US
Practice Address - Phone:661-274-1200
Practice Address - Fax:661-274-1199
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA583572363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily