Healthcare Provider Details

I. General information

NPI: 1366110702
Provider Name (Legal Business Name): ANITA FERNANDES WILLIAMS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANITA FERNANDES HAWKINS RN

II. Dates (important events)

Enumeration Date: 09/01/2021
Last Update Date: 02/25/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1917 S CRISMON RD
MESA AZ
85209-6216
US

IV. Provider business mailing address

1917 S CRISMON RD
MESA AZ
85209-6216
US

V. Phone/Fax

Practice location:
  • Phone: 480-610-7100
  • Fax:
Mailing address:
  • Phone: 480-610-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License NumberRN199270
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number320568
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: