Provider Demographics
NPI:1831591064
Name:DRISCOLL LUNA, ANAYANCY
Entity type:Individual
Prefix:
First Name:ANAYANCY
Middle Name:
Last Name:DRISCOLL LUNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2601
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78540-2601
Mailing Address - Country:US
Mailing Address - Phone:956-600-8199
Mailing Address - Fax:956-600-8301
Practice Address - Street 1:2605 W MILE 5 RD STE E1
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574-0981
Practice Address - Country:US
Practice Address - Phone:956-600-8199
Practice Address - Fax:956-600-8301
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126110363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily