Provider Demographics
NPI:1720315823
Name:ANNA'S ASSISTING PC
Entity Type:Organization
Organization Name:ANNA'S ASSISTING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED FIRST ASSIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:STOIA
Authorized Official - Suffix:
Authorized Official - Credentials:CST, CFA
Authorized Official - Phone:208-880-0204
Mailing Address - Street 1:4401 E TUSCANY AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5082
Mailing Address - Country:US
Mailing Address - Phone:208-880-0204
Mailing Address - Fax:
Practice Address - Street 1:4401 E TUSCANY AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-5082
Practice Address - Country:US
Practice Address - Phone:208-880-0204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-10
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID117520246ZC0007X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty