Provider Demographics
NPI:1780130914
Name:ANUNDSON, BRITTANY (PA-C)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:ANUNDSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:MEIDINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1501 N CAMPBELL AVE BOX 245030
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-5030
Mailing Address - Country:US
Mailing Address - Phone:520-626-6114
Mailing Address - Fax:520-626-1048
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:BOX 245030
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-5030
Practice Address - Country:US
Practice Address - Phone:520-626-6114
Practice Address - Fax:520-626-1048
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6404363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant