Provider Demographics
NPI:1700611647
Name:ANU, MINETTE ATEMAFAC
Entity type:Individual
Prefix:
First Name:MINETTE
Middle Name:ATEMAFAC
Last Name:ANU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12568 E CADEN DR
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-1050
Mailing Address - Country:US
Mailing Address - Phone:520-301-6352
Mailing Address - Fax:
Practice Address - Street 1:12568 E CADEN DR
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:AZ
Practice Address - Zip Code:85641-1050
Practice Address - Country:US
Practice Address - Phone:520-301-6352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ283681163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse