Provider Demographics
NPI:1750558631
Name:CRISTOBAL, ANNA LIZA (RNFA)
Entity type:Individual
Prefix:MISS
First Name:ANNA LIZA
Middle Name:
Last Name:CRISTOBAL
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 HENRIETTA DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-1751
Mailing Address - Country:US
Mailing Address - Phone:973-957-0551
Mailing Address - Fax:866-329-0698
Practice Address - Street 1:20 HENRIETTA DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-1751
Practice Address - Country:US
Practice Address - Phone:973-957-0551
Practice Address - Fax:866-329-0698
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-10
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNO114347163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant