Individual
MISS ANNA MARIE ANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2101 COURAGE DR, FAIRFIELD, CA 94533-6717
(707) 784-2010
Mailing address
2101 COURAGE DR, FAIRFIELD, CA 94533-6717
(707) 784-2010
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP 15006
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP 0150060
—
CA
Enumeration date
10/14/2006
Last updated
11/03/2011
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