Provider Demographics
NPI:1952195083
Name:ANNIM, ANNA A
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:A
Last Name:ANNIM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15584 EMPRESS AVE N UNIT 10
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:MN
Mailing Address - Zip Code:55038-4599
Mailing Address - Country:US
Mailing Address - Phone:612-806-6299
Mailing Address - Fax:612-806-6299
Practice Address - Street 1:15584 EMPRESS AVE N UNIT 10
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:MN
Practice Address - Zip Code:55038-4599
Practice Address - Country:US
Practice Address - Phone:612-806-6299
Practice Address - Fax:612-806-6299
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier