Provider Demographics
NPI:1306978614
Name:CARDINELL, ANNA C (NP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:C
Last Name:CARDINELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:K
Other - Last Name:CARDINELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 232410
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-2410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2055 HIGH ST.
Practice Address - Street 2:#370
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5504
Practice Address - Country:US
Practice Address - Phone:303-839-6001
Practice Address - Fax:303-839-6033
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO111930363LF0000X
CANP95002252363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025570000Medicaid
CO83483071Medicaid
CO83483071Medicaid