Provider Demographics
NPI:1003636705
Name:VARGHESE, ANU (RN)
Entity type:Individual
Prefix:
First Name:ANU
Middle Name:
Last Name:VARGHESE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 CREEKSIDE DR APT 311
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3841
Mailing Address - Country:US
Mailing Address - Phone:469-644-7040
Mailing Address - Fax:
Practice Address - Street 1:1780 CREEKSIDE DR APT 311
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3841
Practice Address - Country:US
Practice Address - Phone:469-644-7040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95386362163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical