Provider Demographics
NPI:1134221914
Name:ANAST, MARY CATHERINE (APRN)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:CATHERINE
Last Name:ANAST
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:CATHERINE
Other - Last Name:MACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:4266 SUNBEAM RD
Mailing Address - Street 2:COMMUNITY HOSPICE & PALLIATIVE CARE
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257
Mailing Address - Country:US
Mailing Address - Phone:352-359-3580
Mailing Address - Fax:352-204-9966
Practice Address - Street 1:4266 SUNBEAM RD
Practice Address - Street 2:COMMUNITY HOSPICE & PALLIATIVE CARE
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257
Practice Address - Country:US
Practice Address - Phone:352-359-3580
Practice Address - Fax:352-204-9966
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60833339363LG0600X
FLARNP3156902363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology