Provider Demographics
NPI:1770590739
Name:NOVAK, ANITA M (CNP)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:M
Last Name:NOVAK
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNM HOSPITAL, 2211 LOMAS NE
Mailing Address - Street 2:DEPARTMENT OF SURGERY, 2ND FLOOR ACC
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106
Mailing Address - Country:US
Mailing Address - Phone:505-414-4507
Mailing Address - Fax:
Practice Address - Street 1:UNM HOSPITAL; 2211 LOMAS NE
Practice Address - Street 2:DEPT OF SURGERY, 2ND FLOOR ACC
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106
Practice Address - Country:US
Practice Address - Phone:505-414-4507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR52698207R00000X
NMCNP01275363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine