Healthcare Provider Details

I. General information

NPI: 1073234639
Provider Name (Legal Business Name): ANEESHI HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5209 W SIESTA WAY
LAVEEN AZ
85339-7179
US

IV. Provider business mailing address

5209 W SIESTA WAY
LAVEEN AZ
85339-7179
US

V. Phone/Fax

Practice location:
  • Phone: 602-550-1008
  • Fax:
Mailing address:
  • Phone: 602-550-1008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KANIZ ISLAM
Title or Position: FNP-BC, PMHNP-BC
Credential: NP
Phone: 602-550-1008