Provider Demographics
NPI:1770260838
Name:ANUKAM, KIANA (FNP-C)
Entity type:Individual
Prefix:
First Name:KIANA
Middle Name:
Last Name:ANUKAM
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:KIANA
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 SPOONBILL DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-1118
Mailing Address - Country:US
Mailing Address - Phone:702-267-7837
Mailing Address - Fax:
Practice Address - Street 1:5964 W PARKER RD STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7788
Practice Address - Country:US
Practice Address - Phone:469-495-9122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1056022363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner