Individual
ANNA ROY
Active
Individual
ANNA ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
041359915
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13543058
CAQH
IL
01
—
209011573
STATE LICENSE - ADVANCED PRACTICE NURSE
IL
01
—
A0513030
AANP - ADULT NURSE PRACTITIONER CERTIFICATION
—
01
—
QXIPQ0000181327
AETNA BETTER HEALTH
IL
Enumeration date
03/18/2015
Last updated
03/07/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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