Provider Demographics
NPI:1952029456
Name:STABLES, ANNAKA KIRSTEN
Entity Type:Individual
Prefix:
First Name:ANNAKA
Middle Name:KIRSTEN
Last Name:STABLES
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 1:18 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-1911
Mailing Address - Country:US
Mailing Address - Phone:301-633-6260
Mailing Address - Fax:
Practice Address - Street 1:14 CENTRAL PARK DR
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-2507
Practice Address - Country:US
Practice Address - Phone:833-579-2429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH076889-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily