Individual
MRS. ANITA S UPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-3583
Mailing address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-3583
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
378014
CA
Other
Enumeration date
11/14/2005
Last updated
10/24/2014
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