# ANNA ELIZABETH MALLOY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1649764358
- **Gender:** F
- **Credential:** CPNP-PC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | SP022972 | PA | Yes |
| 363LP0200X | Pediatric Nurse Practitioner | ARNP9487280 | FL | — |

## Other

- **Enumeration date:** 06/15/2018
- **Last updated:** 04/11/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1038679770001 | — | PA |
| 01 | — | 20180497 | PCNB CERTIFICATION | — |
| 01 | — | ARNP9487280 | FL DEPT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE | FL |
| 01 | — | SP022972 | NP LICENSE PA | PA |