Provider Demographics
NPI:1073658670
Name:NAGGATZ, ANNA W (CRNA)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:W
Last Name:NAGGATZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:W
Other - Last Name:ROCKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:307 S SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561
Mailing Address - Country:US
Mailing Address - Phone:850-712-7130
Mailing Address - Fax:
Practice Address - Street 1:200 HAWTHORNE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2515
Practice Address - Country:US
Practice Address - Phone:704-384-5816
Practice Address - Fax:704-384-5816
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2777672367500000X
FLARNP9447980367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG1753(Z)Medicare ID - Type UnspecifiedPROVIDER #