Provider Demographics
NPI:1487172722
Name:DERANEY, ANNA KATHYRN (NP-C)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:KATHYRN
Last Name:DERANEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-2640
Mailing Address - Country:US
Mailing Address - Phone:978-407-5140
Mailing Address - Fax:
Practice Address - Street 1:360 NORTH AVE
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-1548
Practice Address - Country:US
Practice Address - Phone:800-933-5593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2278213363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily