Doctor Name: | ANNA HRISTOVA |
NPI Number: | 1215334974 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSN, APRN, NP-C |
License Number: | 28192675A |
Business Practice Address: | 2020 E Columbus Dr East Chicago, IN - 463122830 |
Business Phone Number: | 2193978965 |
Business Fax Number: | 2193979351 |
Mailing Address: | 2020 E Columbus Dr, EAST CHICAGO |
State: | IN |
Postal Code: | 463122830 |
Phone Number: | 2193978965 |
Fax Number: | 2193979351 |
NPI Enumeration Date: | 11/24/2014 |
NPI Last Update Date: | 11/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 28192675A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |