Provider Demographics
NPI:1972048825
Name:D'ONOFRIO, ANN MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:ANN MARIE
Middle Name:
Last Name:D'ONOFRIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2623 W WAYNE LN
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-4915
Mailing Address - Country:US
Mailing Address - Phone:623-451-3989
Mailing Address - Fax:
Practice Address - Street 1:2623 W WAYNE LN
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-4915
Practice Address - Country:US
Practice Address - Phone:623-451-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1184363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health