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Individual

ANITA L DESILVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0204
AZ
367500000X
Certified Registered Nurse Anesthetist
RN074439
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
430076548
RAILROAD MEDICARE
AZ
05
719362
AZ
Enumeration date
12/06/2005
Last updated
04/13/2018
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