Provider Demographics
NPI:1952931925
Name:FLORENCKI, ANNA P (NP-C)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:P
Last Name:FLORENCKI
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:P
Other - Last Name:KASTELIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4203 W 217TH ST
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-1141
Mailing Address - Country:US
Mailing Address - Phone:262-352-6830
Mailing Address - Fax:
Practice Address - Street 1:3574 CENTER RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-3618
Practice Address - Country:US
Practice Address - Phone:262-352-6830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-18
Last Update Date:2020-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024957363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily