Provider Demographics
NPI:1154724284
Name:SULAIMAN, ANTHONIA ATINUKE
Entity type:Individual
Prefix:MRS
First Name:ANTHONIA
Middle Name:ATINUKE
Last Name:SULAIMAN
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 1:24221 LA GLORITA CIR
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2303
Mailing Address - Country:US
Mailing Address - Phone:661-609-9864
Mailing Address - Fax:
Practice Address - Street 1:24221 LA GLORITA CIR
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2303
Practice Address - Country:US
Practice Address - Phone:661-609-9864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA595196363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily