Provider Demographics
NPI:1902496185
Name:BLUIT, ANIECA MARIE (MEDICAL ASSISTANT)
Entity Type:Individual
Prefix:MISS
First Name:ANIECA
Middle Name:MARIE
Last Name:BLUIT
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12917 CERISE AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-5520
Mailing Address - Country:US
Mailing Address - Phone:310-675-4431
Mailing Address - Fax:
Practice Address - Street 1:12917 CERISE AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5520
Practice Address - Country:US
Practice Address - Phone:310-675-4431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7517483396374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide