Individual
MARK ANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNPC
Contact information
Practice address
703 AVE G, PLAINS, TX 79355
(806) 456-6365
(806) 456-2057
Mailing address
415 N AVENUE F, DENVER CITY, TX 79323-2741
(806) 592-9501
(806) 592-3052
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
654183
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0075DJ
BLUE CROSS/BLUE SHIELD
TX
01
—
0082EV
BLUE CROSS/BLUE SHIELD
TX
05
—
063623501
—
TX
05
—
137227810
—
TX
Enumeration date
11/03/2005
Last updated
06/27/2008
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