Provider Demographics
NPI:1306257449
Name:HABIMANA, ANITA MUKESHIMANA (MSN, ARNP, WHNP-BC)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:MUKESHIMANA
Last Name:HABIMANA
Suffix:
Gender:F
Credentials:MSN, ARNP, WHNP-BC
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:
Other - Last Name:MUKESHIMANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, ARNP, WHNP-BC
Mailing Address - Street 1:2700 S TAMIAMI TRL
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-4530
Mailing Address - Country:US
Mailing Address - Phone:941-366-7066
Mailing Address - Fax:941-952-9885
Practice Address - Street 1:2700 S TAMIAMI TRL
Practice Address - Street 2:SUITE 5
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-4530
Practice Address - Country:US
Practice Address - Phone:941-366-7066
Practice Address - Fax:941-952-9885
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9235597363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health